American Journal of Epidemiology Vol. 140, No. 7: 608-620
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Physical Activity and Stroke Risk: The Framingham Study
1Department of Neurology, Boston University School of Medicine Boston, MA
2Department of Epidemiology and Biostatistics, Boston University School of Public Health Boston, MA
3Section of Preventive Medicine and Epidemiology, Evans Memorial Department of Clinical Research and Department of Medicine, Boston University School of Medicine Boston, MA
Reprint requests to Dr. Philip A. Wolf, Department of Neurology, Boston University School of Medicine, 80 East Concord Street, B-608, Boston, MA 02118-2334
The authors prospectively examined the influence of increased levels of physical activity on risk of stroke in members of the Framingham Study cohort. Two separate analyses were performed, one during midlife in 1,897 men (mean age = 49.7 years) and 2,299 women (mean age = 49.9 years) and another when the cohort was older (1,361 men (mean age = 63.0) and 1,862 women (mean age = 63.7)). A structured questionnaire administered at two separate examinations was used to estimate the amount of metabolic work done during a typical 24-hour period. Physical activity was categorized into tertiles, and medium and high levels of physical activity were compared with a low level of physical activity, which was used as the referent group. Coxproportional hazards, life table, and time-dependent covariate analyses were used to examine the relation between level of physical activity and stroke risk over a follow-up period of up to 32 years. In men, adjusted analyses revealed that increased levels of physical activity were protective. The strongest effect was obtained from an analysis involving older cohort members in the medium tertile (risk ratio = 0.41, 95% confidence interval 0.24–0.69). High levels of physical activity did not confer an additional benefit over medium levels. Adjusted analyses showed no significant protective effect in women. These results indicate that medium and high levels of physical activity among men are protective against stroke relative to low levels.
cerebrovascular disorders; exercise; physical fitness; proportional hazards models
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