Physical Activity Frequency and Risk of Incident Stroke in a National US Study of Blacks and Whites

McDonnell, Michelle N.; Hillier, Susan; Hooker, Steven P.; Le, Anh; Judd, Suzanne E.; Howard, Virginia J.

doi:10.1161/strokeaha.113.001538

Cited by 104 publications

(73 citation statements)

References 33 publications

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“…However, our study from representative population‐based cohort data showed no significant effect modification by sex, which is consistent with the recent meta‐analysis 19. Another interesting point was that participants with older age or more vascular risk factors performed the highest frequency of MVPA, which is different from the previous results of Western countries 20, 21. Although MVPA had a similar degree of effect on the risk of an ischemic stroke and an intracerebral hemorrhage (20% versus 15% lower risk, respectively), the association was significant in an ischemic stroke, but not in an intracerebral hemorrhage.…”

Section: Discussionsupporting

confidence: 80%

Physical Activity Frequency and the Risk of Stroke: A Nationwide Cohort Study in Korea

Jeong

Kim

Kang

et al. 2017

JAHA

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BackgroundThe current guideline recommends moderate‐ to vigorous‐intensity physical activity (PA) at least 40 min/day for 3 to 4 days/week. Although recent evidence has demonstrated that low‐dose PA could reduce cardiovascular mortality, the relationship between low‐dose PA and the risk of stroke remains uncertain.Methods and ResultsUsing data from a nation‐wide sample cohort in Korea, we examined 336 326 individuals who received a general health examination between 2009 and 2010. Level of PA was assessed using a questionnaire for weekly PA frequencies regarding 3 intensity categories: light, moderate, and vigorous. Moderate‐ to vigorous‐intensity PA (MVPA) was classified into 4 frequency categories: none, 1 to 2, 3 to 4, or ≥5 times/week. Cox proportional hazard models were constructed to estimate the risk of stroke. During the average follow‐up of 3.6 years, 2213 stroke cases occurred. MVPA was none in 50%, 1 to 2 times/week in 20%, 3 to 4 times/week in 13%, and ≥5 times/week in 18% of the cohort. Individuals with MVPA 1 to 2 times/week had a 16% reduced risk of stroke (adjusted hazard ratio, 0.84; 95% confidence interval, 0.73–0.96) compared with those with no MVPA. The population attributable fraction of no MVPA was 12%, which was the second most important risk factor for a stroke after hypertension.ConclusionsEven 1 to 2 times a week of MVPA might be beneficial to prevent a first‐ever stroke in the general population, although a quantitative validation of the questionnaire is needed. From a public health perspective, we need to encourage inactive people to start exercising with more‐achievable goals.

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Section: Discussionsupporting

confidence: 80%

Physical Activity Frequency and the Risk of Stroke: A Nationwide Cohort Study in Korea

Jeong

Kim

Kang

et al. 2017

JAHA

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“…Although this study's findings could not establish a causal relationship between breastfeeding and risk of stroke, health disparities surrounding stroke1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 and breastfeeding rates52, 53, 54 persist. Stroke is 1 of the leading causes of death among Hispanic and non‐Hispanic black women over 65 2, 4.…”

Section: Discussioncontrasting

confidence: 63%

“…Stroke costs the nation $34 billion annually including the cost of healthcare services, medications, and lost productivity 1. Approximately 55 000 more US women than men suffer from a stroke annually 1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16. Compared with elderly men, elderly female stroke survivors are also at increased risk for moderate to severe disability, poorer quality of life, and institutionalization 16, 17…”

Section: Introductionmentioning

confidence: 99%

“…Stroke is higher among Hispanics and non‐Hispanic blacks compared with non‐Hispanic whites 1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18. Hispanic and non‐Hispanic black women are at higher risk of stroke, partially due to increased rates of hypertension, obesity, diabetes mellitus, and physical inactivity,1, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 which are a few stroke risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Jacobson

Hade

Collins

et al. 2018

JAHA

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BackgroundStroke is the third leading cause of death among US Hispanic and non‐Hispanic black women aged 65 and older. One factor that may protect against stroke is breastfeeding. Few studies have assessed the association between breastfeeding and stroke and whether this association differs by race and ethnicity.Methods and ResultsData were taken from the Women's Health Initiative Observational Study with follow‐up through 2010; adjusted hazard ratios for stroke subsequent to childbirth were estimated with Cox regression models accounting for left and right censoring, overall and stratified by race/ethnicity. Of the 80 191 parous women in the Women's Health Initiative Observational Study, 2699 (3.4%) had experienced a stroke within a follow‐up period of 12.6 years. The average age was 63.7 years at baseline. Fifty‐eight percent (n=46 699) reported ever breastfeeding; 83% were non‐Hispanic white, 8% were non‐Hispanic black, 4% were Hispanic, and 5% were of other race/ethnicity. After adjustment for nonmodifiable potential confounders, compared with women who had never breastfed, women who reported ever breastfeeding had a 23% lower risk of stroke (adjusted hazard ratio=0.77; 95% confidence interval 0.70‐0.83). This association was strongest for non‐Hispanic black women (adjusted hazard ratio=0.52; 95% confidence interval 0.37‐0.71). Further, breastfeeding for a relatively short duration (1‐6 months) was associated with a 19% lower risk of stroke (adjusted hazard ratios=0.81; 95% confidence interval 0.74‐0.89). This association appeared stronger with longer breastfeeding duration and among non‐Hispanic white and non‐Hispanic black women (test for trend P<0.01).ConclusionsStudy results show an association and dose‐response relationship between breastfeeding and lower risk of stroke among postmenopausal women after adjustment for multiple stroke risk factors and lifestyle variables. Further investigation is warranted.

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“…In addition, it appears that physical activity can also decrease stroke in primary prevention studies. 44,87 A 2010 meta-analysis demonstrated that an increased level of physical activity has the potential to reduce stroke incidence and stroke-related outcomes.…”

Section: Physical Activitymentioning

confidence: 99%

Antithrombotic selection and risk factor management in ischemic stroke and transient ischemic attack

Katz

Flemming²

2014

FOC

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In addition to appropriate antithrombotic therapy, the identification and treatment of modifiable ischemic stroke risk factors can reduce the likelihood of recurrent stroke. Neurosurgeons should be knowledgeable of the specific risk factors and general recommendations for ischemic stroke, as they may play a significant role in the management options for patients with intracranial and extracranial atherosclerotic disease. The authors of this article review the indications for and selection of antithrombotics in patients with cerebral ischemia. In addition, the identification and secondary prevention of select risk factors are discussed.

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Physical Activity Frequency and Risk of Incident Stroke in a National US Study of Blacks and Whites

Cited by 104 publications

References 33 publications

Physical Activity Frequency and the Risk of Stroke: A Nationwide Cohort Study in Korea

Physical Activity Frequency and the Risk of Stroke: A Nationwide Cohort Study in Korea

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

Antithrombotic selection and risk factor management in ischemic stroke and transient ischemic attack

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