LIFE-STYLE FACTORS AND RISK OF CEREBROVASCULAR-DISEASE IN WOMEN - THECOPENHAGEN CITY HEART-STUDY

Background and Purpose: The purpose of the present analysis was to det ermine how lifestyle influences the risk of cerebrovascular disease in women participating in the Copenhagen City Heart Study. Methods: A ra ndom sample of a white, lower and middle-class, urban population selec ted in 1976 was invited to two cardiovascular examinations at 5-year i ntervals. The present analysis was based on 7060 women invited to an i nitial examination from 1976 through 1978, aged 35 years or more, and without previous stroke or transient ischemic attack. At the initial e xamination, potential risk factors were recorded. The 265 first cases of stroke and transient ischemic attack were ascertained at a second e xamination 5 years later and through hospital records and death certif icates through 1988. The Cox regression model was used to estimate the influence of the factors recorded on the risk of cerebrovascular dise ase. Results: The relative risks of cigarette smoking and lack of phys ical activity were 1.4 and 1.45; 95% confidence limits, 1.02 to 1.94 a nd 1.01 to 2.08, respectively). The relative risk of daily consumption of tranquilizers was 1.25 (95% confidence limits, 0.96 to 1.62). No s ignificant influence was found for number of cigarettes, body mass ind ex, or alcohol intake. In postmenopausal women, there was a statistica lly significant interaction (P<.041) between smoking and hormone repla cement therapy. Smokers receiving this therapy had a 28% lower risk of cerebrovascular disease than smokers not receiving it. Conclusions: T he statistically significant and equally potent effects on the risk of cerebrovascular disease were found for cigarette smoking and lack of physical activity. The risk associated with smoking seemed to be influ enced by hormonal replacement therapy.