Lee I M, Hennekens C H, Berger K, Buring J E, Manson J E
Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass 02215, USA.
Stroke. 1999 Jan;30(1):1-6. doi: 10.1161/01.str.30.1.1.
From a physiological perspective, physical activity might be expected to decrease the risk of developing stroke. However, epidemiological studies of physical activity and stroke risk have yielded divergent findings. We therefore sought to examine the association between exercise and stroke risk.
This was a prospective cohort study of 21 823 men, followed up for an average of 11.1 years. Participants were from the Physicians' Health Study, a randomized trial of low-dose aspirin and beta carotene. Men, aged 40 to 84 years at baseline, were free of self-reported myocardial infarction, stroke, transient ischemic attack, and cancer. At baseline, they reported on the frequency of exercise vigorous enough to work up a sweat. Stroke occurrence was reported by participants and confirmed after medical record review (n=533). We used Cox proportional hazards regression to analyze the data.
With adjustment for age, treatment assignment, smoking, alcohol intake, history of angina, and parental history of myocardial infarction, the relative risks of total stroke associated with vigorous exercise <1 time, 1 time, 2 to 4 times, and >/=5 times per week at baseline were 1.00 (referent), 0.79 (95% confidence interval [CI], 0.61 to 1. 03), 0.80 (95% CI, 0.65 to 0.99), and 0.79 (95% CI, 0.61 to 1.03), respectively; P for trend=0.04. In subgroup analyses, the inverse association appeared stronger with hemorrhagic than ischemic stroke. When we additionally adjusted for body mass index, history of hypertension, high cholesterol, and diabetes mellitus, corresponding relative risks for total stroke were 1.00 (referent), 0.81 (95% CI, 0.61 to 1.07), 0.88 (95% CI, 0.70 to 1.10), and 0.86 (95% CI, 0.65 to 1.13), respectively; P for trend=0.25.
Exercise vigorous enough to work up a sweat is associated with decreased stroke risk in men. In the present study, the inverse association with physical activity appeared to be mediated through beneficial effects on body weight, blood pressure, serum cholesterol, and glucose tolerance. Apart from its favorable influences on these variables, physical activity had no significant residual association with stroke incidence.
从生理学角度来看，体育活动可能会降低中风的发病风险。然而，关于体育活动与中风风险的流行病学研究结果却不尽相同。因此，我们试图研究运动与中风风险之间的关联。
这是一项对21823名男性进行的前瞻性队列研究，平均随访11.1年。参与者来自医生健康研究，这是一项关于低剂量阿司匹林和β-胡萝卜素的随机试验。基线时年龄在40至84岁之间的男性，无自我报告的心肌梗死、中风、短暂性脑缺血发作和癌症。在基线时，他们报告了剧烈运动至出汗的频率。中风的发生由参与者报告，并经病历审查确认（n = 533）。我们使用Cox比例风险回归分析数据。
在对年龄、治疗分配、吸烟、饮酒、心绞痛病史和心肌梗死家族史进行调整后，基线时每周剧烈运动<1次、1次、2至4次和≥5次与总中风相关的相对风险分别为1.00（参照）、0.79（95%置信区间[CI]，0.61至1.03）、0.80（95%CI，0.65至0.99）和0.79（95%CI，0.61至1.03）；趋势P值=0.04。在亚组分析中，与出血性中风相比，这种负相关在缺血性中风中似乎更强。当我们进一步对体重指数、高血压病史、高胆固醇和糖尿病进行调整后，总中风的相应相对风险分别为1.00（参照）、0.81（95%CI，0.61至1.07）、0.88（95%CI，0.70至1.10）和0.86（95%CI，0.65至1.13）；趋势P值=0.25。
剧烈运动至出汗与男性中风风险降低相关。在本研究中，与体育活动的负相关似乎是通过对体重、血压、血清胆固醇和糖耐量的有益影响介导的。除了对这些变量的有利影响外，体育活动与中风发病率没有显著的残余关联。
