From the Department of Neurology (R.L.S., R.G., B.B.-A., D.E.K., W.A.H.,
I-F.L.); Sergievsky Center (R.L.S., W.A.H.); Division of Epidemiology (R.L.S.,
W.A.H., S.S.); Department of Medicine (Division of General Medicine) (S.S.);
and Division of Biostatistics (I-F.L., M.C.P.), Columbia University College of
Physicians and Surgeons and School of Public Health, New York, NY.
Correspondence to Ralph L. Sacco, MD, MS, Neurological Institute, 710 W 168 St, New York, NY 10032. E-mail RLS1{at}Columbia.edu
Background and Purpose—Physical
activity reduces the risk of premature death and
cardiovascular disease, but the relationship to stroke
is less well studied. The objective of this study was to investigate
the association between leisure-time physical activity and
ischemic stroke in an urban, elderly, multiethnic
population.
Methods—The Northern Manhattan Stroke Study is a population-based
incidence and case-control study. Case subjects had first
ischemic stroke, and control subjects were derived through
random-digit dialing with 1:2 matching for age, sex, and
race/ethnicity. Physical activity was recorded through a
standardized in-person interview regarding the frequency and duration
of 14 activities over the 2 prior weeks. Conditional logistic
regression was used to calculate odds ratios (OR) and 95%
confidence intervals after adjustment for medical and socioeconomic
confounders.
Results—Over 30 months, 369 case subjects and 678 control
subjects were enrolled. Mean age was 69.9±12 years; 57% were women,
18% whites, 30% blacks, and 52% Hispanics. Leisure-time physical
activity was significantly protective for stroke after adjustment for
cardiac disease, peripheral vascular disease, hypertension,
diabetes, smoking, alcohol use, obesity, medical reasons for limited
activity, education, and season of enrollment (OR=0.37; 95% confidence
interval=0.25 to 0.55). The protective effect of physical activity was
detected in both younger and older groups, in men and women, and in
whites, blacks, and Hispanics. A dose-response relationship was shown
for both intensity (light-moderate activity OR=0.39; heavy OR=0.23) and
duration (<2 h/wk OR=0.42; 2 to <5 h/wk OR=0.35;
Conclusions—Leisure-time physical activity was related to a
decreased occurrence of ischemic stroke in our elderly,
multiethnic, urban subjects. More emphasis on physical activity in
stroke prevention campaigns is needed among the elderly.
© 1998 American Heart Association, Inc.
Original Contributions
Leisure-Time Physical Activity and Ischemic Stroke Risk
The Northern Manhattan Stroke Study
5 h/wk OR=0.31) of
physical activity.
Key Words: cerebrovascular disorders • elderly • epidemiology • ethnic groups • racial differences • risk factors
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