Physical Activity and Stroke Risk: A Meta-Analysis
Abstract
Background and Purpose— Whether physical activity reduces stroke risk remains controversial. We used a meta-analysis to examine the overall association between physical activity or cardiorespiratory fitness and stroke incidence or mortality. Methods— We searched MEDLINE from 1966 to 2002 and identified 23 studies (18 cohort and 5 case-control) that met inclusion criteria. We estimated the overall relative risk (RR) of stroke incidence or mortality for highly and moderately active individuals versus individuals with low levels of activity using the general variance–based method. Results— The meta-analysis documented that there was a reduction in stroke risk for active or fit individuals compared with inactive or unfit persons in cohort, case-control, and both study types combined. For cohort studies, highly active individuals had a 25% lower risk of stroke incidence or mortality (RR=0.75; 95% CI, 0.69 to 0.82) compared with low-active individuals. For case-control studies, highly active individuals had a 64% lower risk of stroke incidence (RR=0.36; 95% CI, 0.25 to 0.52) than their low-active counterparts. When we combined both the cohort and case-control studies, highly active individuals had a 27% lower risk of stroke incidence or mortality (RR=0.73; 95% CI, 0.67 to 0.79) than did low-active individuals. We observed similar results in moderately active individuals compared with inactive persons (RRs were 0.83 for cohort, 0.52 for case-control, and 0.80 for both combined). Furthermore, moderately and highly active individuals had lower risk of both ischemic and hemorrhagic strokes than low-active individuals. Conclusions— We conclude that moderate and high levels of physical activity are associated with reduced risk of total, ischemic, and hemorrhagic strokes.
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Infectious causes accounted for 18% of deaths among patients with type 1 diabetes in the Allegheny County, Pennsylvania, registry.
“and infectious (18%) causes.70”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [70]
Cardiovascular disease was the leading cause of death among patients with type 1 diabetes in the Allegheny County, Pennsylvania, registry, accounting for 22% of deaths.
“The leading cause of death among patients with type 1 DM is CVD, which accounted for 22% of deaths among those in the Allegheny County, PA, type 1 DM registry,”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [70]
Renal causes accounted for 20% of deaths among patients with type 1 diabetes in the Allegheny County, Pennsylvania, registry.
“followed by renal (20%)”
From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [70]
Lack of physical activity is a risk factor for ASCVD such as CAD and cerebrovascular disease.
“It is also a risk factor for ASCVD such as CAD and cerebrovascular disease577–587).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [583]
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- Authors
- Lee, C. D., Folsom, A. R., & Blair, S. N.
- Affiliations
- University of Minnesota (US)
- Venue
- Stroke
- Published
- 2003-10
- Volume
- 34
- Issue
- 10
- Pages
- 2475-2481
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2084023315
- Cited by
- 829
- References
- 50
- Citations by year
- 2026: 15 · 2025: 40 · 2024: 39 · 2023: 24 · 2022: 36 · 2021: 34 · 2020: 30 · 2019: 41 · 2018: 30 · 2017: 51 · 2016: 41 · 2015: 53 · 2014: 52 · 2013: 45 · 2012: 44
- FWCI
- 13.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (AG06945)
- National Institute on Aging (AG06945)
- National Heart, Lung, and Blood Institute (T32 HL07779, T32HL007779)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- physical activity, stroke risk, cardiorespiratory fitness, stroke incidence, stroke mortality, ischemic stroke, hemorrhagic stroke, stroke prevention
- MeSH terms
- Aged, Australia, Cerebral Hemorrhage, Brain Ischemia, England, Female, Humans, Iceland, Italy, Japan, Male, Middle Aged, Motor Activity, Netherlands, Norway, Physical Fitness, Risk, United States, Cohort Studies, Incidence, Odds Ratio, Case-Control Studies, Stroke, Risk Reduction Behavior
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