Reduction in Incident Stroke Risk With Vigorous Physical Activity: Evidence From 7.7-Year Follow-Up of the National Runners’ Health Study
Open accessAbstract
Background and Purpose— The purpose of this study was to assess the dose–response relationship between vigorous physical activity (running distance, km/d) and the participant-reported physician-diagnosed stroke. Methods— Age-adjusted survival analysis of 29 279 men and 12 123 women followed prospectively for 7.7 years. Results— One hundred men and 19 women reported incident strokes. Per km/d run, the age- and smoking-adjusted risk for stroke decreased 12% in men ( P =0.0007), and 11% in men and women combined ( P =0.001), which remained significant when further adjusted for baseline diabetes, hypercholesterolemia, hypertension, and BMI (8% and 7% reduction per km/d run, respectively, P =0.03). Men and women who ran ≥2 km/d (ie, exceeded the recommended AHA/CDC and NIH guideline activity level) had significantly lower risk than those who ran less ( P =0.05), and those who ran ≥4 km/d had significantly lower risk than those who ran 2 to 3.9 km/d ( P =0.02). Men and women who ran ≥8 km/d were at 60% lower risk than those who ran <2 km/d ( P =0.002). Conclusions— The risk for incident stroke is substantially reduced in those who exceed the guideline physical activity level, which cannot be attributed to less hypertension, diabetes, hypercholesterolemia, or body weight.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Thirteen included papers included women only, and no included studies included only men.
“Thirteen papers included women only,53–65 and no studies included only men.”
From Sex Differences in Physical Activity and Incident Stroke: A Systematic Review (2022) · cites this paper as [59]
The Methods passage describes a cohort of 29,272 men and 12,123 women, so this cited paper is not a women-only study. This paper alone cannot establish whether any other studies included only men. (LLM, conf=0.91)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Compendium of physical activities: an update of activity codes and MET intensities
AINSWORTH, B. E., HASKELL, W. L., WHITT, M. C., IRWIN, M. L., SWARTZ, A. M., STRATH, S. J., O???BRIEN, W. L., BASSETT, D. R., SCHMITZ, K. H., EMPLAINCOURT, P. O., et al. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200009001-00009 · Cited by 8,497 · see citing works
Primary Prevention of Ischemic Stroke
Goldstein, L. B., Adams, R. J., Alberts, M. J., Appel, L. J., Brass, L. M., Bushnell, C., Culebras, A., DeGraba, T. J., Gorelick, P. B., Guyton, J. R., et al. (2006) · Stroke · doi:10.1161/01.str.0000223048.70103.f1 · Cited by 1,359 · see citing works
Physical Activity and Stroke Risk: A Meta-Analysis
Lee, C. D., Folsom, A. R., & Blair, S. N. (2003) · Stroke · doi:10.1161/01.str.0000091843.02517.9d · Cited by 829 · see citing works
Exercise and Risk of Stroke in Male Physicians
Lee, I.-M. M., Hennekens, C. H., Berger, K., Buring, J. E., & Manson, J. E. (1999) · Stroke · doi:10.1161/01.str.30.1.1 · Cited by 272 · see citing works
Vigorous Exercise, Fitness and Incident Hypertension, High Cholesterol, and Diabetes
Williams, P. T. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31816722a9 · Cited by 107 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Heart Disease and Stroke Statistics—2011 Update: A Report From the American Heart Association
Roger, V. L., Go, A. S., Lloyd-Jones, D. M., Adams, R. J., Berry, J. D., Brown, T. M., Carnethon, M. R., Dai, S., de Simone, G., Ford, E. S., et al. (2011) · Circulation · doi:10.1161/cir.0b013e3182009701 · Cited by 6,149 · see citing works
Meschia, J. F., Bushnell, C., Boden-Albala, B., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Elkind, M. S. V., Fornage, M., et al. (2014) · Stroke · doi:10.1161/str.0000000000000046 · Cited by 2,650 · see citing works
Lackland, D. T., Roccella, E. J., Deutsch, A. F., Fornage, M., George, M. G., Howard, G., Kissela, B. M., Kittner, S. J., Lichtman, J. H., Lisabeth, L. D., et al. (2014) · Stroke · doi:10.1161/01.str.0000437068.30550.cf · Cited by 815 · see citing works
Physical activity and risk of cardiovascular disease—a meta-analysis of prospective cohort studies
Li, J., & Siegrist, J. (2012) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph9020391 · Cited by 674 · see citing works
Physical activity and risk of stroke in women
Sattelmair, J. R., Kurth, T., Buring, J. E., & Lee, I.-M. (2010) · Stroke · doi:10.1161/strokeaha.110.584300 · Cited by 112 · see citing works
Huerta, J. M., Chirlaque, M.-D., Tormo, M.-J., Gavrila, D., Arriola, L., Moreno-Iribas, C., Amiano, P., Ardanaz, E., Barricarte, A., Dorronsoro, M., et al. (2013) · Stroke · doi:10.1161/strokeaha.112.670612 · Cited by 44 · see citing works
Sex Differences in Physical Activity and Incident Stroke: A Systematic Review
Madsen, T. E., Samaei, M., Pikula, A., Yu, A. Y. X., Carcel, C., Millsaps, E., Yalamanchili, R. S., Bencie, N., Dula, A. N., Leppert, M., et al. (2022) · Clinical Therapeutics · doi:10.1016/j.clinthera.2022.02.006 · Cited by 27 · see citing works
- Authors
- Williams, P. T.
- Affiliations
- Lawrence Berkeley National Laboratory (US)
- Corresponding author
- Williams, Paul T.
- ORCID
- Williams, Paul T.
- Venue
- Stroke
- Published
- 2009-05
- Volume
- 40
- Issue
- 5
- Pages
- 1921-1923
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC2792566
- OpenAlex
- W2088725941
- Semantic Scholar
- 5692f989b922315c3856c5b6a9ff48601c225a72
- Cited by
- 60
- References
- 6
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 6 · 2017: 5 · 2016: 2 · 2015: 7 · 2014: 6 · 2013: 7 · 2012: 5
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association
- National Institutes of Health
- National Institute on Aging (R03AG032004, AG 032004)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 066738, R01DK066738)
- Lawrence Berkeley National Laboratory
- 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
- high-intensity exercise, running distance, dose-response relationship, physical activity guidelines, cardiovascular risk factors, hypertension, diabetes mellitus, hypercholesterolemia, body mass index
- MeSH terms
- Adult, Body Weight, Female, Follow-Up Studies, Humans, Male, Middle Aged, Physical Fitness, Risk Factors, Running, Body Mass Index, Proportional Hazards Models, Survival Analysis, Risk Assessment, Stroke, Risk Reduction Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
