Findings demonstrate effectiveness of a 2-year multi-domain lifestyle intervention in preventing cerebrovascular events and also total cardiovascular disease (CVD) events among older adults who had a history of CVD.

• Combined prevention of CVD and dementia could decrease the burden of both conditions, and the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed a beneficial impact on cognition (primary outcome).

• Researchers herein examined the impact of this lifestyle intervention on incident CVD (pre-specified secondary outcome) among FINGER participants.

• A total of 1,259 individuals aged 60–77 years were randomized (1:1) to a 2-year multi-domain intervention with diet, physical and cognitive activity, and vascular monitoring (n = 631), or general health advice (n = 628) in the FINGER.

• At least one CVD diagnosis was received by 229 participants (18%) during an average of 7.4 years: 107 in the intervention group and 122 in the control group.

• A lower incidence of cerebrovascular events was reported in the intervention vs the control group: hazard ratio (HR) for combined stroke/transient ischemic attack (TIA) was 0.71 post-adjustment for background characteristics.

• For coronary events and total CVD events, the estimated HRs were 0.84 and 0.80, respectively.

• Among participants with a history of CVD (n = 145), those who received intervention were found to have a lower incidence of both total CVD events (HR: 0.50) and stroke/TIA (HR: 0.40), compared with the control group.