LIFELONG EXERCISE AND STROKE

Objectives-To examine the potential of lifelong patterns of increased physical activity to prevent stroke. Design-Case-control study. Settin g-11 general practices in west Birmingham. Subjects-125 men and women who had just had their first stroke and were aged 35-74 and 198 contro ls frequency matched for age and sex recruited over 24 months during 1 988-90. Exclusion criteria were a previous history of stroke, mitral v alvular heart disease combined with atrial fibrillation, primary or me tastatic cerebral neoplasm, or coagulation disorder or myeloproliferat ive disease. Main outcome measures-Odds ratios for stroke related to l ifetime history of exercise after 15 years of age. Results-A history o f vigorous exercise during the ages 15-25 appeared to protect from str oke: odds ratio adjusted for age and sex 0.33 (95% confidence interval 0.2 to 0.6). This effect was independent of other potential risk fact ors. Increasing years of participation in vigorous exercise between th e ages of 15 and 55 produced an increasing protection from stroke (p<0 .001). In the 65 cases and 169 controls who were free of cardiac ischa emia, peripheral vascular disease, and poor health recent vigorous exe rcise and walking were protective against stroke: odds ratios of 0.41 (0.2 to 1.0) for recent vigorous exercise and 0.30 (0.1 to 0.7) for re cent walking. Conclusions-Appreciable protection from stroke in later life is conferred by vigorous exercise in early adulthood. This increa sed level of physical activity should, if possible, be continued lifel ong.