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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