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Association of physical activity level and stroke outcomes in men and women: a meta-analysis.
J Womens Health (Larchmt) 2010; 19(10):1815-22JW

Abstract

OBJECTIVE

The protective effect of physical activity (PA) on risk of stroke remains controversial as a result of lack of insight into the sources of heterogeneity between studies. We performed a comprehensive meta-analysis of studies to (1) quantify the association between PA level and risk of stroke outcomes and (2) test the hypothesis that the association of PA level with stroke outcomes will be similar between men and women. The outcome measures are stroke incidence, stroke mortality, or both.

METHODS

Cohort studies were identified by searching MEDLINE and EMBASE (from 1986 to 2005) and meta-analysis conducted according to meta-analysis of Observational Studies in Epidemiology (MOOSE) group recommendations. Data were reported as pooled relative risk (RR) and 95% confidence intervals (CI) using random-effects models to assess the association of stroke outcomes with PA level. Heterogeneity was investigated, and sensitivity analysis was performed. Stratified analysis by gender was performed.

RESULTS

Of 992 articles, 13 satisfied all eligibility criteria and were studied. Compared with low PA, moderate PA caused an 11% reduction in risk of stroke outcome (RR = 0.89, 95% CI 0.86-0.93, p < 0.01) and high PA a 19% reduction (RR = 0.81, CI 0.77-0.84, p < 0.01). Among the men, results showed a 12% reduction in risk associated with moderate PA (RR = 0.88, CI 0.82-0.94, p < 0.01) and 19% reduction for high PA (RR = 0.81, CI 0.75-0.87, p < 0.01). Among the women, results showed a 24% reduction in risk for high PA (RR = 0.76, CI 0.64-.89, p < 0.01). There was, however, no significant risk reduction associated with a moderate PA level in women.

CONCLUSIONS

Increased PA level appears beneficial in reduction of risk of stroke and related outcomes. However, higher levels of PA may be required in women to achieve as significant a risk reduction as in men. An exercise regimen tailored to women to improve related physiological mechanisms will likely be beneficial.

Authors+Show Affiliations

Graduate Training Program in Clinical Investigation, Johns Hopkins University Medical Institutions, Baltimore, Maryland, USA. ldiep@howard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

20929415

Citation

Diep, Lien, et al. "Association of Physical Activity Level and Stroke Outcomes in Men and Women: a Meta-analysis." Journal of Women's Health (2002), vol. 19, no. 10, 2010, pp. 1815-22.
Diep L, Kwagyan J, Kurantsin-Mills J, et al. Association of physical activity level and stroke outcomes in men and women: a meta-analysis. J Womens Health (Larchmt). 2010;19(10):1815-22.
Diep, L., Kwagyan, J., Kurantsin-Mills, J., Weir, R., & Jayam-Trouth, A. (2010). Association of physical activity level and stroke outcomes in men and women: a meta-analysis. Journal of Women's Health (2002), 19(10), pp. 1815-22. doi:10.1089/jwh.2009.1708.
Diep L, et al. Association of Physical Activity Level and Stroke Outcomes in Men and Women: a Meta-analysis. J Womens Health (Larchmt). 2010;19(10):1815-22. PubMed PMID: 20929415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of physical activity level and stroke outcomes in men and women: a meta-analysis. AU - Diep,Lien, AU - Kwagyan,John, AU - Kurantsin-Mills,Joseph, AU - Weir,Roger, AU - Jayam-Trouth,Annapurni, PY - 2010/10/9/entrez PY - 2010/10/12/pubmed PY - 2013/2/5/medline SP - 1815 EP - 22 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 19 IS - 10 N2 - OBJECTIVE: The protective effect of physical activity (PA) on risk of stroke remains controversial as a result of lack of insight into the sources of heterogeneity between studies. We performed a comprehensive meta-analysis of studies to (1) quantify the association between PA level and risk of stroke outcomes and (2) test the hypothesis that the association of PA level with stroke outcomes will be similar between men and women. The outcome measures are stroke incidence, stroke mortality, or both. METHODS: Cohort studies were identified by searching MEDLINE and EMBASE (from 1986 to 2005) and meta-analysis conducted according to meta-analysis of Observational Studies in Epidemiology (MOOSE) group recommendations. Data were reported as pooled relative risk (RR) and 95% confidence intervals (CI) using random-effects models to assess the association of stroke outcomes with PA level. Heterogeneity was investigated, and sensitivity analysis was performed. Stratified analysis by gender was performed. RESULTS: Of 992 articles, 13 satisfied all eligibility criteria and were studied. Compared with low PA, moderate PA caused an 11% reduction in risk of stroke outcome (RR = 0.89, 95% CI 0.86-0.93, p < 0.01) and high PA a 19% reduction (RR = 0.81, CI 0.77-0.84, p < 0.01). Among the men, results showed a 12% reduction in risk associated with moderate PA (RR = 0.88, CI 0.82-0.94, p < 0.01) and 19% reduction for high PA (RR = 0.81, CI 0.75-0.87, p < 0.01). Among the women, results showed a 24% reduction in risk for high PA (RR = 0.76, CI 0.64-.89, p < 0.01). There was, however, no significant risk reduction associated with a moderate PA level in women. CONCLUSIONS: Increased PA level appears beneficial in reduction of risk of stroke and related outcomes. However, higher levels of PA may be required in women to achieve as significant a risk reduction as in men. An exercise regimen tailored to women to improve related physiological mechanisms will likely be beneficial. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/20929415/Association_of_physical_activity_level_and_stroke_outcomes_in_men_and_women:_a_meta_analysis_ L2 - https://www.liebertpub.com/doi/full/10.1089/jwh.2009.1708?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -