Association between physical activity and risk of stroke subtypes: the atherosclerosis risk in communities study
Open accessAbstract
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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For ischemic stroke, among 10 papers including women and men, 5 (50%) suggested similar effects in women and men.
“For ischemic stroke, of 10 papers including women and men, 5(50%) suggested similar effects in women and men”
From Sex Differences in Physical Activity and Incident Stroke: A Systematic Review (2022) · cites this paper as [30]
The Results (page unavailable) confirm that this paper examined ischemic stroke associations separately in women and men. They report a much stronger association in men and no significant association in women. The paper does not report a tally of 10 papers or establish that 5 found similar effects across sexes. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAmong those 17 papers, 3 (18%) showed a significant effect of physical activity on total stroke in men but not in women.
“3 (18%) of studies showed a significant effect in men but not in women”
From Sex Differences in Physical Activity and Incident Stroke: A Systematic Review (2022) · cites this paper as [30]
Seven studies (37%) demonstrated no evidence for reduced risk of incident ischemic stroke associated with physical activity in women.
“and 7 (37%) demonstrated no evidence for reduced risk of incident stroke associated with physical activity.30,34,37,42,48,56,65”
From Sex Differences in Physical Activity and Incident Stroke: A Systematic Review (2022) · cites this paper as [30]
Eight studies (29%) reported a non-significant association between physical activity and incident total stroke in women.
“and eight (29%) reported a non-significant association between physical activity and incident total stroke.30,33,35,41,56,62,64,65”
From Sex Differences in Physical Activity and Incident Stroke: A Systematic Review (2022) · cites this paper as [30]
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- Authors
- Autenrieth, C. S., Evenson, K. R., Yatsuya, H., Shahar, E., Baggett, C., & Rosamond, W. D.
- Affiliations
- Helmholtz Munich (DE)
- University of North Carolina at Chapel Hill (US)
- University of Minnesota (US)
- Venue
- Neuroepidemiology
- Publisher
- S. Karger AG
- Published
- 2012-10-24
- Volume
- 40
- Issue
- 2
- Pages
- 109-116
- ISSN
- 0251-5350 (ISSN-L)
- 1423-0208
- PMC
- PMC3641888
- OpenAlex
- W2029733429
- Semantic Scholar
- 3ddc1254937861aa5f106246d51e3e0377e531e5
- Cited by
- 46
- References
- 28
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 2 · 2014: 6 · 2013: 5
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neuroepidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Site cant be reached (submittedVersion)
- Funders
- U.S. Public Health Service (HHSN262801100006C, HHSN262801100010C, HHSN262801100009C, HHSN262801100008C, HHSN262801100007C, HHSN262801100011C, HHSN262801100012C)
- National Heart, Lung, and Blood Institute (HHSN268201 100012C, HHSN268201100007I, HHSN268201100007C, HHSN2682 01100008C, HH-SN-268201100006C, HHSN268201100011C, HHSN2682011-00005I, HHSN2682011-00009I, HHSN268201100005C, HHSN268201100005G, HHSN268201100010C, HHSN268201100011I, HHSN268200900020C, HHSN26820 1100009C, HHSN2682011, HHSN2682011-00008I)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- physical activity, stroke subtypes, ischemic stroke, lacunar stroke, cardioembolic stroke, cardiovascular health, ideal cardiovascular health, African Americans, sex differences, middle-aged adults, Atherosclerosis Risk in Communities Study
- MeSH terms
- Black or African American, Intracranial Arteriosclerosis, Female, Humans, Leisure Activities, Male, Middle Aged, Motor Activity, Prospective Studies, Sports, United States, Cohort Studies, Incidence, Risk Assessment, Stroke
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