Physical activity frequency and risk of incident stroke in a national US study of blacks and whites
Open accessAbstract
Background and Purpose—: Regular physical activity (PA) is an important recommendation for stroke prevention. We compared the associations of self-reported PA with incident stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Methods—: REGARDS recruited 30 239 US blacks (42%) and whites, aged ≥45 years with follow-up every 6 months for stroke events. Excluding those with prior stroke, analysis involved 27 348 participants who reported their frequency of moderate to vigorous intensity PA at baseline according to 3 categories: none (physical inactivity), 1 to 3×, and ≥4× per week. Stroke and transient ischemic attack cases were identified during an average of 5.7 years of follow-up. Cox proportional hazards models were constructed to examine whether self-reported PA was associated with risk of incident stroke. Results—: Physical inactivity was reported by 33% of participants and was associated with a hazard ratio of 1.20 (95% confidence intervals, 1.02–1.42; P =0.035). Adjustment for demographic and socioeconomic factors did not affect hazard ratio, but further adjustment for traditional stroke risk factors (diabetes mellitus, hypertension, body mass index, alcohol use, and smoking) partially attenuated this risk (hazard ratio, 1.14 [0.95–1.37]; P =0.17). There was no significant association between PA frequency and risk of stroke by sex groups, although there was a trend toward increased risk for men reporting PA 0 to 3× a week compared with ≥4× a week. Conclusions—: Self-reported low PA frequency is associated with increased risk of incident stroke. Any effect of PA is likely to be mediated through reducing traditional risk factors.
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Effect estimates in included studies were mostly relative measures such as hazard ratios or relative risks, though 3 papers reported absolute measures such as population attributable risk percents.
“Effect estimates were mostly relative measures of the association between physical activity and incident stroke (either hazard ratios or relative risks), though 3 papers29,34,47 reported absolute measures of effect such as population attributable risk percents.”
From Sex Differences in Physical Activity and Incident Stroke: A Systematic Review (2022) · cites this paper as [47]
The Statistical analysis and Results sections report this study’s effect estimates as hazard ratios, not population-attributable risk percents. The population-attributable risk of 28.5% mentioned in the background is explicitly attributed to the separate INTERSTROKE study, so it is not an absolute effect estimate from this paper. (LLM, conf=0.87)
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- Authors
- McDonnell, M. N., Hillier, S. L., Hooker, S. P., Le, A., Judd, S. E., & Howard, V. J.
- Affiliations
- University of South Australia (AU)
- Venue
- Stroke
- Published
- 2013-09
- Volume
- 44
- Issue
- 9
- Pages
- 2519-2524
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC3809059
- OpenAlex
- W2135822008
- Cited by
- 122
- References
- 37
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 15 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 14 · 2018: 9 · 2017: 19 · 2016: 7 · 2015: 10 · 2014: 15 · 2013: 4 · 2012: 2
- FWCI
- 8.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, other-oa)
- UniSA Research Outputs Repository (University of South Australia) (submittedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health
- National Health and Medical Research Council
- National Institute of Neurological Disorders and Stroke (U01NS041588)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- physical activity, stroke risk, physical inactivity, moderate-to-vigorous physical activity, transient ischemic attack, racial differences, black and white populations, stroke risk factors, sex differences, REGARDS study
- MeSH terms
- Aged, Black or African American, Ischemic Attack, Transient, Female, Follow-Up Studies, Health Surveys, Humans, Male, Middle Aged, Motor Activity, Risk Factors, Time Factors, United States, Incidence, Stroke, Black People, White People, Self Report
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