Exercise and risk of stroke in male physicians.
Exercise and risk of stroke in male physicians.
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DOI：
10.1097/00005768-199605001-00656
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发表时间：
1996-05
期刊：
影响因子：
8.3
通讯作者：
I. Lee;J. Manson;Julie E. Buring;K. Berger;C. Hennekens
中科院分区：
文献类型：
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作者：
I. Lee;J. Manson;Julie E. Buring;K. Berger;C. Hennekens
背景和目的从生理学的角度来看，体力活动有望降低发生中风的风险。然而，对体力活动和中风风险的流行病学研究得出了不同的结论。因此，我们试图研究锻炼和中风风险之间的联系。方法对21823名男性进行前瞻性队列研究，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。男性，基线年龄在40到84岁之间，没有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，他们报告了足够剧烈的运动频率，以排出一身汗。卒中发生由参与者报告，并经医疗记录审查后确认(n=533)。数据分析采用COX比例风险回归分析。结果在调整了年龄、治疗任务、吸烟、饮酒、心绞痛史和父母心肌梗死病史后，基线时每周5次剧烈运动与总卒中相关的相对危险度分别为1.00(参照)、0.79(95%可信区间，0.61~1.03)、0.80(95%可信区间，0.65~0.99)和0.79(95%可信区间，0.61~1.03)；趋势P=0.04。在亚组分析中，出血性卒中的反向关联似乎比缺血性卒中更强。当我们额外调整体重指数、高血压、高胆固醇和糖尿病病史时，总卒中的相对危险度分别为1.00(参考)、0.81(95%CI，0.61~1.07)、0.88(95%CI，0.70~1.10)和0.86(95%CI，0.65~1.13)；趋势P=0.25。结论：运动强度大到出一身汗与男性中风风险降低有关。在目前的研究中，与体力活动相反的联系似乎是通过对体重、血压、血清胆固醇和葡萄糖耐量的有益影响来调节的。除了对这些变量的有利影响外，体力活动与中风发生率没有显著的残留关联。
BACKGROUND AND PURPOSE 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. METHODS 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. RESULTS 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 /=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. CONCLUSIONS 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.