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Physical activity and risk of ischemic stroke in the Northern Manhattan Study
Open accessAbstract
BACKGROUND: It is controversial whether physical activity is protective against first stroke among older persons. We sought to examine whether physical activity, as measured by intensity of exercise and energy expended, is protective against ischemic stroke. METHODS: The Northern Manhattan Study is a prospective cohort study in older, urban-dwelling, multiethnic, stroke-free individuals. Baseline measures of leisure-time physical activity were collected via in-person questionnaires. Cox proportional hazards models were constructed to examine whether energy expended and intensity of physical activity were associated with the risk of incident ischemic stroke. RESULTS: Physical inactivity was present in 40.5% of the cohort. Over a median follow-up of 9.1 years, there were 238 incident ischemic strokes. Moderate- to heavy-intensity physical activity was associated with a lower risk of ischemic stroke (adjusted hazard ratio [HR] 0.65, 95% confidence interval [0.44-0.98]). Engaging in any physical activity vs none (adjusted HR 1.16, 95% CI 0.88-1.51) and energy expended in kcal/wk (adjusted HR per 500-unit increase 1.01, 95% CI 0.99-1.03) were not associated with ischemic stroke risk. There was an interaction of sex with intensity of physical activity (p = 0.04), such that moderate to heavy activity was protective against ischemic stroke in men (adjusted HR 0.37, 95% CI 0.18-0.78), but not in women (adjusted HR 0.92, 95% CI 0.57-1.50). CONCLUSIONS: Moderate- to heavy-intensity physical activity, but not energy expended, is protective against risk of ischemic stroke independent of other stroke risk factors in men in our cohort. Engaging in moderate to heavy physical activities may be an important component of primary prevention strategies aimed at reducing stroke risk.
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“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 [57]
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Self-citation
Metadata
- Authors
- Willey, J. Z., Moon, Y. P., Paik, M. C., Boden-Albala, B., Sacco, R. L., & Elkind, M. S. V.
- Affiliations
- Columbia University (US)
- Venue
- Neurology
- Published
- 2009-11-24
- Volume
- 73
- Issue
- 21
- Pages
- 1774-1779
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC2788811
- OpenAlex
- W4297157268
- Semantic Scholar
- 3ef3ddf7785906f7e995e3578840a1cb2d46f889
- Cited by
- 122
- References
- 33
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 10 · 2021: 7 · 2020: 13 · 2019: 4 · 2018: 6 · 2017: 11 · 2016: 6 · 2015: 8 · 2014: 10 · 2013: 8 · 2012: 7
- FWCI
- 4.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ns062820-05, R37 NS29993)
- U.S. Public Health Service (R01 047655)
- National Institute on Aging (L30 AG031009)
- National Heart, Lung, and Blood Institute (HC-98-08-HC-83169701)
- National Institute of Neurological Disorders and Stroke (NS048134, T32 NS-07153, R01NS55809, R01NS040807, P50NS049060, R01NS048134, R37NS029993, R01-NS062820, R01NS050724, T32NS007153, R01NS055809, R37 NS 29993.)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Clinical Neurology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- physical activity, ischemic stroke, stroke risk, exercise intensity, energy expenditure, older adults, sex differences, primary prevention, Northern Manhattan Study
- MeSH terms
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Motor Activity, New York City, Risk Factors, Cohort Studies, Confidence Intervals, Proportional Hazards Models, Stroke
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