Changes in physical activity and risk of ischemic stroke: The ARIC study

Area of Science:

• Cardiovascular Epidemiology
• Public Health
• Gerontology

Background:

• Limited research exists on how changes in physical activity (PA) over time affect ischemic stroke risk.
• Understanding this relationship is vital for developing effective stroke prevention strategies and promoting lifelong PA.

Purpose of the Study:

• To investigate the association between changes in physical activity levels over a six-year period and the risk of ischemic stroke.
• To determine if maintaining, increasing, or decreasing physical activity impacts long-term stroke risk.

Main Methods:

• Analysis of 11,089 participants from the Atherosclerosis Risk in Communities (ARIC) study, recruited between 1987-1989.
• Classification of physical activity into categories: meeting recommendations, not meeting recommendations, or no PA, and evaluation of changes between Visit 1 and Visit 3 (a 6-year interval).
• Utilized Cox regression models to assess the association between 6-year changes in PA and ischemic stroke risk over a median follow-up of 21 years.

Main Results:

• Compared to those meeting PA recommendations at both visits, participants with no PA had a 46% higher risk of ischemic stroke.
• Individuals who were active at Visit 1 but inactive at Visit 3 showed a 37% increased hazard for ischemic stroke.
• Increasing PA from Visit 1 to Visit 3 was associated with a 23% lower hazard compared to maintaining low PA, while decreasing PA increased stroke hazard by 25% compared to maintaining high PA.

Conclusions:

• Physical inactivity during midlife is a significant risk factor for developing ischemic stroke.
• Meeting physical activity recommendations in midlife is associated with a reduced risk of ischemic stroke.
• Changes in physical activity levels, particularly decreases, impact long-term ischemic stroke risk.