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(Stroke. 2005;36:1994.)
© 2005 American Heart Association, Inc.

Original Contributions

Leisure Time, Occupational, and Commuting Physical Activity and the Risk of Stroke

Gang Hu, PhD; Cinzia Sarti, PhD; Pekka Jousilahti, PhD; Karri Silventoinen, PhD; Noël C. Barengo, MD Jaakko Tuomilehto, PhD

From the Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland (G.H., C.S., P.J., J.T.); Department of Public Health, University of Helsinki, Finland (G.H., C.S., P.J., K.S., J.T.); Department of Public Health and General Practice, University of Kuopio, Finland (N.C.B.); and South Ostrobothnia Central Hospital, Seinäjoki, Finland (J.T.).

Correspondence to Gang Hu, MD, PhD, Department of Epidemiology and Health Promotion, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. E-mail hu.gang{at}ktl.fi

Background and Purpose— The role of physical activity, especially that of occupational and commuting physical activity, in the prediction of stroke risk is not properly established. We assessed the relationship of different types of physical activity with total and type-specific stroke risk.

Methods— We prospectively followed 47 721 Finnish subjects 25 to 64 years of age without a history of coronary heart disease, stroke, or cancer at baseline. Hazard ratios (HRs) for incident stroke were estimated for different levels of leisure time, occupational, and commuting physical activity.

Results— During a mean follow-up of 19.0 years, 2863 incident stroke events were ascertained. The multivariate-adjusted (age, sex, area, study year, body mass index, systolic blood pressure, cholesterol, education, smoking, alcohol consumption, diabetes, and other 2 types of physical activity) HRs associated with low, moderate, and high leisure time physical activity were 1.00, 0.86, and 0.74 (P_trend<0.001) for total stroke, 1.00, 0.87, and 0.46 (P_trend=0.011) for subarachnoid hemorrhage, 1.00, 0.77, and 0.63 (P_trend=0.024) for intracerebral hemorrhage, and 1.00, 0.87, and 0.80 (P_trend=0.001) for ischemic stroke, respectively. The multivariate-adjusted HRs associated with none, 1 to 29, and 30 minutes of active commuting were 1.00, 0.92, and 0.89 (P_trend=0.043) for total stroke, and 1.00, 0.93, and 0.86 (P_trend=0.028) for ischemic stroke, respectively. Occupational activity had a modest association with ischemic stroke in the multivariate analysis (P_trend=0.046).

Conclusion— A high level of leisure time physical activity reduces the risk of all subtypes of stroke. Daily active commuting also reduces the risk of ischemic stroke.

Key Words: exercise • incidence • stroke

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