Leisure-Time Physical Activity and Ischemic Stroke Risk

Abstract

Background and Purpose-Physical activity reduces the risk of premature death and cardiovascular disease, but the relationship to stroke is less well studied. The objective of this study was to investigate the association between leisure-time physical activity and ischemic stroke in an urban, elderly, multiethnic population. Methods-The Northern Manhattan Stroke Study is a population-based incidence and case-control study. Case subjects had first ischemic stroke, and control subjects were derived through random-digit dialing with 1:2 matching for age, sex, and race/ethnicity. Physical activity was recorded through a standardized in-person interview regarding the frequency and duration of 14 activities over the 2 prior weeks. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals after adjustment for medical and socioeconomic confounders. Results-Over 30 months, 369 case subjects and 678 control subjects were enrolled. Mean age was 69.9Ϯ12 years; 57% were women, 18% whites, 30% blacks, and 52% Hispanics. Leisure-time physical activity was significantly protective for stroke after adjustment for cardiac disease, peripheral vascular disease, hypertension, diabetes, smoking, alcohol use, obesity, medical reasons for limited activity, education, and season of enrollment (ORϭ0.37; 95% confidence intervalϭ0.25 to 0.55). The protective effect of physical activity was detected in both younger and older groups, in men and women, and in whites, blacks, and Hispanics. A dose-response relationship was shown for both intensity (light-moderate activity ORϭ0.39; heavy ORϭ0.23) and duration (Ͻ2 h/wk ORϭ0.42; 2 to Ͻ5 h/wk ORϭ0.35; Ն5 h/wk ORϭ0.31) of physical activity. Conclusions-Leisure-time physical activity was related to a decreased occurrence of ischemic stroke in our elderly, multiethnic, urban subjects. More emphasis on physical activity in stroke prevention campaigns is needed among the elderly. (Stroke. 1998;29:380-387.)

Task-oriented treadmill exercise training in chronic hemiparetic stroke

“…Reduced physical activity levels after stroke may also contribute to poor cardiovascular-metabolic health and an increased risk for recurrent cerebrovascular events [15]. Physical fitness and cardiovascular health are integrally related, with epidemiological studies indicating physical inactivity is associated with increased risk for incident stroke [16].…”

Physical Activity and Exercise Recommendations for Stroke Survivors

“…Evidence is accumulating that stroke risk can be reduced with regular leisure-time physical activity in multiethnic individuals of all ages and both sexes. 28 Recently, the association between baseline cardiorespiratory fitness and stroke mortality was investigated in 16 878 apparently healthy men, aged 40 to 87 years, with the Aerobics Center Longitudinal Study database. 25 During an average of 10 years of follow-up, men in the moderate-and high-fitness groups had a 63% and 68% lower risk of stroke death, respectively, than men who were in the lowest-fitness group at baseline.…”

“…48 -50 Evidence is accumulating that stroke risk can be reduced with regular leisure-time physical activity in multiethnic individuals of all ages and both sexes. 28 Evidence now suggests that the exercise trainability of stroke survivors may be comparable to that of age-matched healthy counterparts. 10,16 -18,56 Extrapolation of what is known about the training effects of regular exercise by able-bodied individuals suggests that certain levels of exercise that are achieved during many stroke rehabilitation programs may improve aerobic fitness.…”

Primary Prevention of Ischemic Stroke

“…The beneficial effects of physical activity have also been documented for stroke. [165][166][167][168][169][170][171][172][173] The Framingham Heart Study, Honolulu Heart Program, and Oslo Study have shown the protective effect of physical activity for men. 166 -168 For women, the Nurses' Health Study and Copenhagen City Heart Study demonstrated an inverse association between level of physical activity and stroke incidence.…”

“…Additional protection was observed with increasing duration of exercise; however, the prevalence of such activities in the elderly was quite low. 172 The protective effect of physical activity may be mediated in part through its role in controlling various known risk factors for stroke, such as hypertension, 175 cardiovascular disease, 176 diabetes, 177 and body weight. Other biological mechanisms are also associated with physical activity, including reductions in plasma fibrinogen and platelet activity, as well as elevations in plasma tissue plasminogen activator activity and HDL concentrations.…”