Polygenic Risk Score Stratification Guides Prioritization of Modifiable Risk Factors for Stroke Prevention

Background: Integrating polygenic scores (PGS) into population-based stroke prevention strategies may help reduce the stroke burden at both individual and population levels. However, prospective evidence regarding the interaction between genetic and modifiable risk factors remains limited, particularly in East Asian populations. Methods: We evaluated the influence of modifiable risk factors across PGS levels in the prospective population-based Tohoku Medical Megabank Community-Based Cohort Study. Stroke PGS was calculated using a model developed by the GIGASTROKE project. Results: During a median follow-up of 4.84 years (121,843.2 person-years), 246 incident stroke events were identified. Co