Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
Division of General Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Int J Stroke. 2023 Feb;18(2):173-179. doi: 10.1177/17474930221094221. Epub 2022 May 9.
Limited data exist regarding the impact of changes in physical activity (PA) over time on ischemic stroke risk. Exploring this understudied area could help improve stroke prevention strategies and promote PA during the lifespan.
We evaluated 11,089 Atherosclerosis Risk in Communities (ARIC) participants recruited in 1987-1989 who completed Visit 3 (1993-1995). We classified PA as meeting recommendations, not meeting recommendations, or no PA. Categories of increased, decreased, stable high, and stable low PA and a continuous PA variable were also evaluated. Crude and adjusted Cox regression models were used to characterize the association of 6-year changes in PA and ischemic stroke risk.
Participants had a mean age of 60 years. During a median of 21 years, 762 ischemic stroke events occurred. Compared to the participants with recommended PA at both visits, those with no PA had 46% higher hazards of ischemic stroke (hazard ratio (HR) = 1.46 (95% confidence interval (CI) = 1.17, 1.82)), and those with recommended PA at Visit 1 and no PA at Visit 3 also had 37% higher hazards (HR = 1.37 (95% CI = 1.02, 1.83)). Participants who increased their PA from Visit 1 to Visit 3 had 23% lower hazard than those with stable low PA at both visits (HR = 0.77 (95% CI = 0.63, 0.94)), while those who decreased their PA had 25% higher hazards compared to those with stable high PA at both visits (HR = 1.25 (95% CI = 1.01, 1.54)).
Physical inactivity during midlife increases ischemic stroke risk, while meeting PA recommendations reduces it.
关于体力活动（PA）随时间变化对缺血性中风风险的影响，相关数据有限。探索这一研究不足的领域有助于改善中风预防策略，并促进一生中的 PA。
我们评估了 1987-1989 年招募的 11089 名动脉粥样硬化风险社区（ARIC）参与者，他们完成了第 3 次访问（1993-1995 年）。我们将 PA 分为符合建议、不符合建议和无 PA。还评估了增加、减少、稳定高和稳定低 PA 的类别以及连续 PA 变量。使用粗和调整后的 Cox 回归模型来描述 6 年 PA 变化与缺血性中风风险的关联。
参与者的平均年龄为 60 岁。在中位数为 21 年的时间里，发生了 762 例缺血性中风事件。与两次访问均符合 PA 建议的参与者相比，无 PA 的参与者缺血性中风的危险比高 46%（危险比（HR）=1.46（95%置信区间（CI）=1.17，1.82）），而在第 1 次访问时符合 PA 建议，而在第 3 次访问时无 PA 的参与者也有 37%的危险比更高（HR=1.37（95%CI=1.02，1.83））。与两次访问均有稳定低 PA 的参与者相比，从第 1 次访问到第 3 次访问增加 PA 的参与者的危险比降低了 23%（HR=0.77（95%CI=0.63，0.94）），而降低 PA 的参与者的危险比比两次访问均有稳定高 PA 的参与者高 25%（HR=1.25（95%CI=1.01，1.54））。
中年时期缺乏体力活动会增加缺血性中风的风险，而符合 PA 建议则会降低这种风险。
