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(Stroke. 2003;34:2481.)
© 2003 American Heart Association, Inc.

Original Contributions

Editorial Commen: Physical Exercise and Stroke: The Sitting Majority Has a Lesson to Learn

Department of Neurology and Neurosciences Center, Donauklinikum and Danube University, Maria Gugging, Austria

An extract of the first 250 words of the full text is provided, because this article has no abstract.

One of the most simple, natural, and cheapest ways of preventing a stroke is to exercise regularly. In spite of this trivial wisdom it is hard to get people to increase their cardiovascular fitness, probably because no direct gains are visible and no immediate rewards are attached. One report from Canada estimates that about two thirds of the population are inactive, and the public health burden resulting from this amounts to 2.5% of total direct health costs.¹ For this sitting majority there is now a lesson to be learned. Lee et al report in this issue of Stroke² a meta-analysis of all studies published up to mid-2002, including epidemiological as well as case-control studies, showing a clear benefit of physical activity to prevent both stroke incidence and mortality. The magnitude of the effect is considerable, homogenous, and significant: highly active individuals had a 21% lower risk of ischemic stroke and a 34% lower risk of hemorrhagic stroke when compared with low-active individuals.

What has also become evident is that no large differences exist between countries. The studies for this meta-analysis have come from North America and include data from the Framingham cohort and the Northern Manhattan Stroke Study. Other data are from the United Kingdom, Scandinavia, Netherlands, Japan, and Australia. The pooled results show unequivocally that high-level physical activity should become a global recommendation for stroke prevention. Not considering malnutrition and social impoverishment as contributing causes of stroke in less developed countries, there is no reason to assume that physical . . . [Full Text of this Article]