Association between physical activity and risk of stroke subtypes: The atherosclerosis risk in communities study

Christine S. Autenrieth, Kelly R. Evenson, Hiroshi Yatsuya, Eyal Shahar, Christopher Baggett, Wayne D. Rosamond

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: The relationship between stroke subtypes and physical activity is unclear. Methods: Using data from 13,069 men and women aged 45-64 years who participated in the Atherosclerosis Risk in Communities Study, physical activity was assessed by self-report using the Baecke questionnaire at baseline (1987-1989). The American Heart Association's ideal cardiovascular health guidelines served as a basis for the calculation of three physical activity categories: poor, intermediate, and ideal. Stroke and its subtypes were ascertained from physician review of medical records. Multivariable adjusted hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models. Results: During a median follow-up of 18.8 years, a total of 648 incident ischemic strokes occurred. Significant inverse associations were found between physical activity categories and total, total ischemic, and nonlacunar stroke in adjusted models (age, sex, race-center, education, cigarette-years). Compared with poor physical activity, the adjusted HR (95% CI) for ideal physical activity were 0.78 (0.62-0.97) for total, 0.76 (0.59-0.96) for total ischemic, 0.85 (0.51-1.40) for lacunar, 0.77 (0.47-1.27) for cardioembolic, and 0.71 (0.51-0.99) for nonlacunar stroke. Additional adjustments for waist-to-hip ratio, systolic blood pressure, antihypertensive medication, diabetes, left ventricular hypertrophy and laboratory parameters attenuated the HR. Further sex-and race-specific analyses revealed that the association was predominantly observed among males and among African-Americans. Conclusion: These data suggest a tendency toward a reduced risk of total, total ischemic, and nonlacunar stroke with higher levels of physical activity.

Original languageEnglish
Pages (from-to)109-116
Number of pages8
JournalNeuroepidemiology
Volume40
Issue number2
DOIs
Publication statusPublished - 01-02-2013

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Atherosclerosis
Stroke
Exercise
Confidence Intervals
Blood Pressure
American Heart Association
Waist-Hip Ratio
Left Ventricular Hypertrophy
Proportional Hazards Models
Tobacco Products
African Americans
Self Report
Antihypertensive Agents
Medical Records
Guidelines
Physicians
Education
Health

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Clinical Neurology

Cite this

Autenrieth, Christine S. ; Evenson, Kelly R. ; Yatsuya, Hiroshi ; Shahar, Eyal ; Baggett, Christopher ; Rosamond, Wayne D. / Association between physical activity and risk of stroke subtypes : The atherosclerosis risk in communities study. In: Neuroepidemiology. 2013 ; Vol. 40, No. 2. pp. 109-116.
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abstract = "Background: The relationship between stroke subtypes and physical activity is unclear. Methods: Using data from 13,069 men and women aged 45-64 years who participated in the Atherosclerosis Risk in Communities Study, physical activity was assessed by self-report using the Baecke questionnaire at baseline (1987-1989). The American Heart Association's ideal cardiovascular health guidelines served as a basis for the calculation of three physical activity categories: poor, intermediate, and ideal. Stroke and its subtypes were ascertained from physician review of medical records. Multivariable adjusted hazard ratios (HR) and 95{\%} confidence intervals (CI) were calculated using Cox regression models. Results: During a median follow-up of 18.8 years, a total of 648 incident ischemic strokes occurred. Significant inverse associations were found between physical activity categories and total, total ischemic, and nonlacunar stroke in adjusted models (age, sex, race-center, education, cigarette-years). Compared with poor physical activity, the adjusted HR (95{\%} CI) for ideal physical activity were 0.78 (0.62-0.97) for total, 0.76 (0.59-0.96) for total ischemic, 0.85 (0.51-1.40) for lacunar, 0.77 (0.47-1.27) for cardioembolic, and 0.71 (0.51-0.99) for nonlacunar stroke. Additional adjustments for waist-to-hip ratio, systolic blood pressure, antihypertensive medication, diabetes, left ventricular hypertrophy and laboratory parameters attenuated the HR. Further sex-and race-specific analyses revealed that the association was predominantly observed among males and among African-Americans. Conclusion: These data suggest a tendency toward a reduced risk of total, total ischemic, and nonlacunar stroke with higher levels of physical activity.",
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Association between physical activity and risk of stroke subtypes : The atherosclerosis risk in communities study. / Autenrieth, Christine S.; Evenson, Kelly R.; Yatsuya, Hiroshi; Shahar, Eyal; Baggett, Christopher; Rosamond, Wayne D.

In: Neuroepidemiology, Vol. 40, No. 2, 01.02.2013, p. 109-116.

Research output: Contribution to journalArticle

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T1 - Association between physical activity and risk of stroke subtypes

T2 - The atherosclerosis risk in communities study

AU - Autenrieth, Christine S.

AU - Evenson, Kelly R.

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AU - Baggett, Christopher

AU - Rosamond, Wayne D.

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