ABSTRACT NUMBER: ESOC2026A875 IMPACT OF HEALTHY LIFESTYLE FACTORS ON STROKE RISK: A PROSPECTIVE COHORT STUDY IN EGYPTIAN ADULTS

Abstract Background and aims Evidence linking healthy lifestyle factors with stroke risk remains limited. Identifying modifiable behaviors is crucial for stroke prevention. Aim of this study is to prospectively examine the impact of multiple healthy lifestyle factors on the risk of stroke and its subtypes. Methods A total of 562 stroke-free participants aged 30–79 years were prospectively followed from March 2023 to April 2025 at Al-Hussein University Hospital and Cairo Fatemia Hospital. Seven lifestyle factors were assessed: non-smoking, moderate alcohol consumption, sufficient physical activity, healthy diet, 7–9 hours of sleep per day, and standard BMI and waist-to-hip ratio. A healthy lifestyle score (0–7) was calculated based on the number of factors present. Cox proportional hazards models estimated hazard ratios (HRs) for total stroke and ischemic stroke. Results Participants with scores ≥6 had a 48% lower risk of total stroke (HR 0.52, 95% CI 0.31–0.88) and a 50% lower risk of ischemic stroke (HR 0.50, 95% CI 0.28–0.89) compared with those scoring ≤2. Each 1-point increase in the healthy lifestyle score was associated with a 13% reduction in total stroke risk (HR 0.87, 95% CI 0.78–0.97) and a similar reduction for ischemic stroke (HR 0.87, 95% CI 0.77–0.97). Conclusions Adherence to multiple healthy lifestyle behaviors significantly lowers stroke risk, with incremental benefits as the number of healthy factors increases. These findings support the implementation of comprehensive lifestyle interventions for stroke prevention. Conflict of interest nothing to disclose