Purpose To report methodological details and feasibility of conducting an accelerometer ancillary study in a large U.S. cohort being followed for stroke and cognitive decline. Methods REGARDS is a national, population-based study of 30,239 blacks and whites, aged ≥ 45 years, enrolled January 2003–October 2007. Baseline evaluations were conducted through computer-assisted telephone interview (CATI) and an in-home visit. Participants are followed by CATI every 6 months. Starting with May 2009 follow-up, contingent on accelerometer availability, participants were invited to wear an accelerometer for 7 days. Device inventory was 1,150. Accelerometer, instructions, log sheet and stamped addressed return envelope were mailed to consenting participants. Postcard acknowledgement and reminders, and ≤ two calls were made to encourage compliance. Results Between May 2009 and January 2013, 20,076 were invited to participate; 12,146 (60.5%) consented. Participation rates by race-sex groups were similar: black women 58.6%, black men 59.6%, white women 62.3% and white men 60.5%. Mean age of the 12,146 participants to whom devices were shipped was 63.5 ± 8.7 years. Return rate was 92%. Of 11,174 returned, 1,187 were not worn, 14 had device malfunction, and of 9,973 with data, 8,096 (81.2%) provided usable data, defined as ≥ 4 days of 10+ hours of wear time, ranging from 74.4% among black women to 85.2% among white men. Conclusions Using mail and telephone methods, it is feasible to obtain objective measures of physical activity from a sizeable proportion of a national cohort of adults, with similar participation rates among blacks and whites. Linked with the clinical health information collected through follow-up, these data will allow future analyses on the association between objectively-measured sedentary time, physical activity and health outcomes.

Background The association between lipid levels and stroke rates is less than lipid levels and coronary heart disease (CHD) Objective To assess if there are geographic, racial, and ethnic differences in total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol(HDL-C) and triglyceride levels with incident stroke. Methods From The REasons for Geographic AndRacial Differences in Stroke (REGARDS) study we evaluated baseline levels of LDL-C, HCL-C, TC, Non-HDL-C (Total - HDL-C) and triglycerides in participants free of prevalent stroke at baseline. Cox Proportional-Hazard models were the main analytical tool used to examine the association between incident stroke and lipids. For each adjusted lipid measure (LDL-C, HDL-C, triglycerides, TC, and non-HDL-C) we calculated a series of incremental models. Results The analysis cohort was 23,867 participants with a mean follow-up time of 7.5 +/− 2.9 years, and 1031 centrally adjudicated strokes (874 ischemic and 77 hemorrhagic strokes). HDL-C baseline level was associated with an overall unadjusted 13% risk reduction (HR 0.87, 95% confidence interval [CI]: 0.81–0.93; p<0.05; 14% for ischemic and 16% for hemorrhagic strokes), and TC with an 8% (HR 0.92, 95%CI: 0.87–0.99; p<0.05) risk reduction of all strokes. When the results were fully adjusted a significant association was observed only for LDL-C and non-HDL-C and ischemic stroke. There were no significant differences in these associations when adjusted for age, race, age*race, gender, education, region, or income. Conclusion In a disease free population, LDL-C and non-HDL-C baseline levels are significantly associated with the risk of ischemic stroke.

PP is positively associated with incident stroke, but not independently from SBP; and, there were no significant gender, racial, or regional differences in that association.

Among older adults, those who used to, but no longer, drink had higher risks of stroke, especially among women; current light drinkers had the lowest risk of stroke.

Background Circulatory and vascular changes across consecutive pregnancies may increase the risk of later-life cerebrovascular health outcomes. Methods The association between parity and incident stroke was assessed among 7674 white and 6280 black women, aged 45+, enrolled in the REGARDS Study from 2003-2007. Parity was assessed at baseline, and incident stroke was ascertained from physician-adjudicated medical records through September 2014. Cox proportional hazards models were used to estimate hazard ratios (HR) for the association between parity and stroke, adjusting for baseline measures. Results At baseline, 12.7% of white women and 16.2% of black women reported 1 live birth, while 8.2% and 19.0%, respectively, reported ≥5 live births. Mean follow-up time was 7.5 years (SD=2.8); there were 447 incident strokes. A significant interaction between race and parity was detected (p=0.05). Among white women, those with ≥5 live births had a higher stroke risk than those with 1 live birth (HR=1.57; 95% CI 0.93-2.65). However, the association was eliminated after adjustment for baseline characteristics (HR=1.00, 95% CI 0.59-1.71). For black women, those with ≥5 live births had the highest stroke risk compared to those with 1 live birth (HR=1.91, 95% CI 1.25-2.93), but the association was attenuated and no longer statistically significant after adjustment for confounders (HR=1.40, 95% CI 0.89-2.18). Conclusion In adjusted models, no statistically significant associations were observed between parity and stroke risk in a diverse cohort of U.S. women. Further studies are needed to elucidate the role of lifestyle and psychosocial factors in the race-specific associations that were observed.