Effects of leisure-time physical activity and ventilatory function on riskfor stroke in men: The Reykjavik study

Background: Stroke is a major ca use of illness, death, and health expendit ures. Leisure-time physical activity may reduce the risk for stroke. Objective: To examine the association of leisure-time physical activity and pulmonary function with risk for stroke. Design: Prospective cohort study. Setting: Reykjavik, Iceland. Participants: 4484 men 45 to 80 yea rs of age followed for a mean (+/- SD) of 10.6 +/- 3.6 years. Measurements: Patients underwent physical examination, blood sampling, and spirometry and completed a questionnaire about health and exercise. Compute rized hospital records were used to identify strokes, and the Icelandic Nat ional Registry was used to identify deaths. Results: New stroke developed in 249 men (5.6%) (hemorrhagic stroke in 44 [ 18%] and ischemic stroke in 205 [82%]). In a multivariable hazard analysis that controlled for known risk factors for cerebrovascular disease, leisure -time physical activity maintained after 40 years of age was associated wit h a reduced risk for stroke (relative risk, 0.69 [Cl, 0.47 to 1.01] for tot al stroke and 0.62 [Cl, 0.40 to 0.97] for ischemic stroke). Risk for stroke increased with diminished ventilatory function (FVC or FEV1) (relative ris k, 1.9 [Cl, 1.06 to 3.25] for the lowest compared with the highest quintile ). Conclusion: Middle-aged men who participate in leisure-time physical activi ty and have good pulmonary function seem to have a lower risk for stroke th an men who are not active or have diminished pulmonary function.