The interaction between lifestyle and blood pressure on Stroke: A cross-sectional study from Northern China

Q: What are the key findings of this study?

Elevated systolic blood pressure (≥180 mmHg) was associated with an increased incidence of stroke (OR 1.648) compared to <140 mmHg, with synergistic risks observed alongside unhealthy lifestyle factors.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Stroke (n=34995). Intervention: Elevated systolic blood pressure (≥ 180 mmHg) vs. Normal systolic blood pressure (< 140 mmHg). Primary outcome: Incidence of stroke (OR 1.648, 95% CI 1.175-2.313, p=0.001).

Q: What does this research mean for the field?

Elevated systolic and diastolic blood pressure significantly increase stroke risk, and this effect is synergistically amplified by unhealthy lifestyle factors such as smoking, alcohol consumption, obesity, and physical inactivity. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Jiantao Yu; Qiang Zhou; Yanyan Zhao; Haiying Chen; Huiyong Yu; Yuying Li; xiuguo Zhang

doi:10.1371/journal.pone.0344016

March 9, 2026PLoS ONEOpen Access

The interaction between lifestyle and blood pressure on Stroke: A cross-sectional study from Northern China

View Full Paper

Ask AI

Bookmark

Share

Key result

Systolic BP ≥180 mmHg linked to ~65% higher stroke odds, compounded by unhealthy lifestyle factors.

OR 1.648
95% CI 1.175-2.313
P=0.001
n=34,995

Figures

Key Points

To determine how systolic and diastolic blood pressure interact with modifiable lifestyle behaviors to influence the incidence of stroke among older individuals.
Analyzed cross-sectional data from 34,995 older adults aged 65–103 years (mean age 71.91 ± 5.65 years) in Northern China.
Assessed systolic blood pressure (SBP), diastolic blood pressure (DBP), and lifestyle risk factors including smoking, alcohol consumption, obesity, and physical inactivity.
Applied multivariable logistic regression and multiplicative interaction models adjusting for sociodemographic characteristics and clinical comorbidities.
Compared with SBP Q1 (< 140 mmHg; 591/23,760 events), stroke risk increased across Q2 (211/7,825 events; OR = 1.086, 95% CI: 0.926–1.274), Q3 (85/2,493 events; OR = 1.384, 95% CI: 1.098–1.744), and Q4 (37/917 events; OR = 1.648, 95% CI: 1.175–2.313; Ptrend = 0.001).
Each 1 mmHg increase in SBP and DBP was associated with an adjusted stroke odds ratio of OR = 1.008 (95% CI: 1.004–1.012) and OR = 1.012 (95% CI: 1.005–1.019), respectively.
Unhealthy lifestyle behaviors synergistically amplified stroke risk alongside elevated blood pressure, with smoking status significantly modifying the association between DBP and stroke (P for interaction = 0.031).

Study Design

Type

Cross-Sectional (n=34,995)

Multicenter

Yes

Structured PICO

P

Population

34,995 adults aged 65 years and older from northern China, evaluated for the joint association of blood pressure and lifestyle factors on the prevalence of stroke.

E

Exposure

Elevated systolic and diastolic blood pressure interacting with unhealthy lifestyle factors (smoking, alcohol consumption, physical inactivity, and obesity)

O

Outcome

Incidence of stroke (defined as subarachnoid hemorrhage, intracerebral hemorrhage, or cerebral ischemic necrosis based on self-reported medical history and neurologist assessment)hard clinical

Main Result

Odds Ratio: 1.648 (95% CI 1.175–2.313)

Absolute Event Rate: 4.03% vs 2.49%

p-value: p=0.001

Unhealthy lifestyle factors such as smoking, alcohol consumption, physical inactivity, and obesity synergistically amplify the risk of stroke associated with elevated systolic and diastolic blood pressure in older adults.

Limitations

Observational design precludes establishing causality and reverse causality cannot be excluded
Residual confounding from unmeasured variables such as diet, sleep quality, and inflammatory markers
Self-reported lifestyle factors may introduce recall bias and potential misclassification
Transport-related physical activity was not evaluated
Study population was drawn from a single province in northern China, limiting broader generalizability

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

May support integrated BP-lifestyle strategies; leaves open causal confirmation in prospective studies.

Abstract

This study demonstrated that elevated systolic and diastolic blood pressure were significantly associated with a higher incidence of stroke. A synergistic effect was observed between unhealthy lifestyle factors (such as smoking, alcohol consumption, obesity, and physical inactivity) and elevated blood pressure in increasing stroke risk. Smoking partially mediated the relationship between diastolic blood pressure and stroke. These findings highlight the potential benefit of integrated control strategies targeting both blood pressure and modifiable lifestyle factors.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Yu et al. (2026) conducted a cross-sectional in Stroke (n=34,995). Elevated systolic blood pressure (≥ 180 mmHg) vs. Normal systolic blood pressure (< 140 mmHg) was evaluated on Incidence of stroke (OR 1.648, 95% CI 1.175-2.313, p=0.001). Elevated systolic blood pressure (≥180 mmHg) was associated with an increased incidence of stroke (OR 1.648) compared to <140 mmHg, with synergistic risks observed alongside unhealthy lifestyle factors.

synapsesocial.com/papers/69b2584996eeacc4fcec7bbf https://doi.org/10.1371/journal.pone.0344016

View Full Paper

Ask AI

Bookmark

Share

The interaction between lifestyle and blood pressure on Stroke: A cross-sectional study from Northern China

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The interaction between lifestyle and blood pressure on Stroke: A cross-sectional study from Northern China

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading