Hu F B, Stampfer M J, Colditz G A, Ascherio A, Rexrode K M, Willett W C, Manson J E
Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115.
JAMA. 2000 Jun 14;283(22):2961-7. doi: 10.1001/jama.283.22.2961.
Persuasive evidence has demonstrated that increased physical activity is associated with substantial reduction in risk of coronary heart disease. However, the role of physical activity in the prevention of stroke is less well established.
To examine the association between physical activity and risk of total stroke and stroke subtypes in women.
The Nurses' Health Study, a prospective cohort study of subjects residing in 11 US states.
A total of 72,488 female nurses aged 40 to 65 years who did not have diagnosed cardiovascular disease or cancer at baseline in 1986 and who completed detailed physical activity questionnaires in 1986, 1988, and 1992.
Incident stroke occurring between baseline and June 1, 1994, compared among quintiles of physical activity level as measured by metabolic equivalent tasks (METs) in hours per week.
During 8 years (560,087 person-years) of follow-up, we documented 407 incident cases of stroke (258 ischemic strokes, 67 subarachnoid hemorrhages, 42 intracerebral hemorrhages, and 40 strokes of unknown type). In multivariate analyses controlling for age, body mass index, history of hypertension, and other covariates, increasing physical activity was strongly inversely associated with risk of total stroke. Relative risks (RRs) in the lowest to highest MET quintiles were 1. 00, 0.98, 0.82, 0.74, and 0.66 (P for trend=.005). The inverse gradient was seen primarily for ischemic stroke (RRs across increasing MET quintiles, 1.00, 0.87, 0.83, 0.76, and 0.52; P for trend=.003). Physical activity was not significantly associated with subarachnoid hemorrhage or intracerebral hemorrhage. After multivariate adjustment, walking was associated with reduced risk of total stroke (RRs across increasing walking MET quintiles, 1.00, 0. 76, 0.78, 0.70, and 0.66; P for trend=.01) and ischemic stroke (RRs across increasing walking MET quintiles, 1.00, 0.77, 0.75, 0.69, and 0.60; P for trend=.02). Brisk or striding walking pace was associated with lower risk of total and ischemic stroke compared with average or casual pace.
These data indicate that physical activity, including moderate-intensity exercise such as walking, is associated with substantial reduction in risk of total and ischemic stroke in a dose-response manner. JAMA. 2000.
有说服力的证据表明，增加身体活动与冠心病风险大幅降低相关。然而，身体活动在预防中风方面的作用尚不明确。
研究女性身体活动与总中风风险及中风亚型之间的关联。
护士健康研究，一项对居住在美国11个州的受试者进行的前瞻性队列研究。
共有72488名年龄在40至65岁之间的女性护士，她们在1986年基线时未被诊断患有心血管疾病或癌症，并在1986年、1988年和1992年完成了详细的身体活动问卷。
1994年6月1日前基线至随访期间发生的中风事件，按每周代谢当量任务（METs）小时数衡量的身体活动水平五分位数进行比较。
在8年（560087人年）的随访期间，我们记录了407例中风事件（258例缺血性中风、67例蛛网膜下腔出血、42例脑出血和40例不明类型中风）。在控制年龄、体重指数、高血压病史和其他协变量的多变量分析中，身体活动增加与总中风风险呈强烈负相关。MET五分位数从最低到最高的相对风险（RRs）分别为1.00、0.98、0.82、0.74和0.66（趋势P值 = 0.005）。这种负梯度主要见于缺血性中风（MET五分位数增加时的RRs分别为1.00、0.87、0.83、0.76和0.52；趋势P值 = 0.003）。身体活动与蛛网膜下腔出血或脑出血无显著关联。多变量调整后，步行与总中风风险降低相关（步行MET五分位数增加时的RRs分别为1.00、0.76、0.78、0.70和0.66；趋势P值 = 0.01）以及缺血性中风（步行MET五分位数增加时的RRs分别为1.00、0.77、0.75、0.69和0.60；趋势P值 = 0.02）。与平均或随意步速相比，轻快或大步走步速与总中风和缺血性中风风险较低相关。
这些数据表明，包括步行等中等强度运动在内的身体活动与总中风和缺血性中风风险以剂量反应方式大幅降低相关。《美国医学会杂志》。2000年
