Lastly, even for individuals within risk factor levels recommended by current guidelines (SBP < 120, BMI < 25, not currently smoking, no diagnosed diabetes), our models predict substantial differences in risk between different metaGRS levels. These results suggest that for individuals with high metaGRS, achieving currently recommended risk factor levels may not be sufficient and that it is time to contemplate whether future guidelines on primary and secondary stroke prevention should integrate genetic information when defining treatment goals for high-risk individuals. Ultimately, the practical implications of these results to stroke risk screening in the general population will require public health modelling, taking into account what is considered ‘high risk’ of stroke in the context of each country and health system, and the efficacy of interventions or treatments that are available for risk reduction.
