The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here:

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Isabel Drake

Isabel Drake

Associate professor

Isabel Drake

Modifiable and non-modifiable risk factors for atherothrombotic ischemic stroke among subjects in the malmö diet and cancer study


  • Anna Johansson
  • Isabel Drake
  • Gunnar Engström
  • Stefan Acosta

Summary, in English

Risk factors for ischemic stroke is suggested to differ by etiologic subtypes. The purpose of this study was to examine the associations between modifiable and non-modifiable risk factors and atherothrombotic stroke (i.e., excluding cardioembolic stroke), and to examine if the potential benefit of modifiable lifestyle factors differs among subjects with and without predisposing comorbidities. After a median follow-up of 21.2 years, 2339 individuals were diagnosed with atherothrombotic stroke out of 26,547 study participants from the Malmö Diet and Cancer study. Using multivariable Cox regression, we examined non-modifiable (demographics and family history of stroke), semi-modifiable comorbidities (hypertension, dyslipidemia, diabetes mellitus and atherosclerotic disease), and modifiable (smoking, body mass index, diet quality, physical activity, and alcohol intake) risk factors in relation to atherothrombotic stroke. Higher age, male gender, family history of stroke, and low educational level increased the risk of atherothrombotic stroke as did predisposing comorbidities. Non-smoking (hazard ratio (HR) = 0.62, 95% confidence interval (CI) 0.56–0.68), high diet quality (HR = 0.83, 95% CI 0.72–0.97) and high leisure-time physical activity (HR = 0.89, 95% CI 0.80–0.98) decreased the risk of atherothrombotic ischemic stroke independent of established risk factors, with non-significant associations with body mass index and alcohol intake. The effect of the lifestyle factors was independent of predisposing comorbidities at baseline. The adverse effects of several cardiovascular risk factors were confirmed in this study of atherothrombotic stroke. Smoking cessation, improving diet quality and increasing physical activity level is likely to lower risk of atherothrombotic stroke in the general population as well as in patient groups at high risk.


  • Vascular Diseases - Clinical Research
  • Diabetes - Cardiovascular Disease
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Cardiovascular Research - Epidemiology

Publishing year










Document type

Journal article




  • Cardiac and Cardiovascular Systems


  • Atherothrombotic
  • Diet
  • Epidemiology
  • Ischemic stroke
  • Lifestyle
  • Physical activity
  • Risk factors




  • Food components and domains of physical activity in relation to atherothrombotic ischemic stroke

Research group

  • Vascular Diseases - Clinical Research
  • Diabetes - Cardiovascular Disease
  • Cardiovascular Research - Epidemiology


  • ISSN: 2072-6643