Stroke, Vol 24, 1468-1472, Copyright © 1993 by American Heart Association
E Lindenstrom, G Boysen and J Nyboe
BACKGROUND AND PURPOSE: The purpose of the present analysis was to
determine how lifestyle influences the risk of cerebrovascular disease in
women participating in the Copenhagen City Heart Study. METHODS: A random
sample of a white, lower and middle-class, urban population selected in
1976 was invited to two cardiovascular examinations at 5- year intervals.
The present analysis was based on 7060 women invited to an initial
examination from 1976 through 1978, aged 35 years or more, and without
previous stroke or transient ischemic attack. At the initial examination,
potential risk factors were recorded. The 265 first cases of stroke and
transient ischemic attack were ascertained at a second examination 5 years
later and through hospital records and death certificates through 1988. The
Cox regression model was used to estimate the influence of the factors
recorded on the risk of cerebrovascular disease. RESULTS: The relative
risks of cigarette smoking and lack of physical activity were 1.4 and 1.45;
95% confidence limits, 1.02 to 1.94 and 1.01 to 2.08, respectively). The
relative risk of daily consumption of tranquilizers was 1.25 (95%
confidence limits, 0.96 to 1.62). No significant influence was found for
number of cigarettes, body mass index, or alcohol intake. In postmenopausal
women, there was a statistically significant interaction (P < .041)
between smoking and hormone replacement therapy. Smokers receiving this
therapy had a 28% lower risk of cerebrovascular disease than smokers not
receiving it. CONCLUSIONS: The statistically significant and equally potent
effects on the risk of cerebrovascular disease were found for cigarette
smoking and lack of physical activity. The risk associated with smoking
seemed to be influenced by hormonal replacement therapy.
ARTICLES
Lifestyle factors and risk of cerebrovascular disease in women. The Copenhagen City Heart Study
Rigshospitalet, Department of Neurology, Copenhagen, Denmark.
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