Key result
Advanced education level was associated with a 25% decreased rate of incident total stroke (HR 0.75) compared to basic education over a median follow-up of 25.3 years.
Why the study?
The study aimed to characterize the association between education and incident stroke, including total, ischemic, and hemorrhagic stroke, and assess whether a causal relationship exists.
Does higher education level reduce the incidence of stroke in adults?
Cohort (n=11,509)
Yes
Does higher education level reduce the incidence of stroke in adults?
Hazard Ratio: 0.75 (95% CI 0.62–0.91)
Absolute Event Rate: 6.2% vs 11.6%
p-value: p=0.004
Higher educational attainment is associated with a decreased risk of incident total and ischemic stroke, with Mendelian randomization supporting a potential causal protective effect for ischemic stroke.
Should not yet change clinical practice; leaves open causal effects of education on stroke for interventional trials.
We aim to characterize the association between education and incident stroke (including total stroke, ischemic stroke, and hemorrhagic stroke) and assess whether there is a causal relationship between them. The final sample size was 11,509 in this study from the Atherosclerosis Risk in Communities (ARIC) study. Cox hazard regression models were used to explore the association between education level and incident stroke. Two-sample Mendelian randomization (MR) was used to estimate the causality. During a median follow-up of 25.3 years, 915 cases (8.0%) of stroke occurred. Participants with advanced education level were associated with 25% (HR 0.75; 95% CI 0.62, 0.91) decreased the rate of incident total stroke. Hazard ratio of intermediate and advanced education level for ischemic stroke were 0.82 (0.69, 0.98) and 0.73 (0.60, 0.90) separately. In the MR analysis, we observed evidence that education was likely a negetive causal risk factor for ischemic stroke (OR 0.764, 95% CI 0.585-0.998, P = 0.048). Higher education level was associated with a decreased rate of total stroke and ischemic stroke incident, but not hemorrhagic stroke incident. There might be a protective causal association between education and ischemic stroke (but not total stroke nor hemorrhagic stroke).
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Xiuyun et al. (2020) conducted a cohort in Incident stroke (n=11,509). Advanced education level vs. Basic education level was evaluated on Incident total stroke (HR 0.75, 95% CI 0.62, 0.91, p=0.004). Advanced education level was associated with a 25% decreased rate of incident total stroke (HR 0.75) compared to basic education over a median follow-up of 25.3 years.
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