Physical Activity and the Risk of Hemorrhagic Stroke: A Population-Based Longitudinal Follow-Up Study in Taiwan.

Shih-Hao Feng,Shin-Liang Pan,Li-Sheng Chen,Kuo-Cheng Yeh

doi:10.3389/fmed.2021.791772

Abstract

Background: Data on the relationship between physical activity (PA) and hemorrhagic stroke (HS) are limited in Asian populations. This population-based longitudinal follow-up study therefore investigates whether PA is associated with a reduced risk of HS in Taiwan.Methods: A total of 58,857 subjects who had participated in the Keelung Community-based Integrated Screening Program between 2005 and 2012 were enrolled. Information about their PA, obtained using questionnaires, was used to categorize them into three groups according to their average weekly time engaged in it: (1) no PA, (2) low PA (<90 min weekly), and (3) high PA (90 min per week or more). Cox proportional hazard regression was used to evaluate the effect of PA on HS. Stratified analysis by sex and comorbidities (diabetes mellitus, hypertension, and hyperlipidemia) were conducted to evaluate their impact on the relationship between PA and HS.Results: Compared to the no-PA group, the adjusted hazard ratio of HS for the low-PA group was 0.74 (95% CI, 0.57–0.96, p = 0.0219), and for the high-PA group, 0.72 (95% CI, 0.58–0.90, p = 0.004). The stratified analyses showed that, for the non-comorbidity strata, the beneficial effect of PA on reducing HS risk became stronger as PA increased. However, in the diabetes and hypertension strata, high PA did not appear to have any greater protective effect than low PA.Conclusions: Our findings suggested that even <90 min of PA per week might be beneficial to reduce HS risk. Such a low level of PA is likely to be more achievable and easier to maintain for the general population. Additionally, personalized recommendations based on pre-existing comorbidities may help optimize the beneficial effects of PA on HS prevention.

Highlights

Stroke is a leading cause of death and disability worldwide
The present study has shown that low PA (LPA) and high PA (HPA) were both associated a reduced risk of hemorrhagic stroke (HS), as compared with NPA; and, as can be seen in Table 2, this risk reduction appeared to be of a similar magnitude for both LPA and HPA
The present study has shown that even

Summary

Introduction

Stroke is a leading cause of death and disability worldwide. Up to 80% of strokes can be prevented through the management of risk factors such as hypertension, diabetes mellitus (DM) [1], smoking, and physical inactivity [2]. Most of the prior studies regarding the relationship between PA and HS were conducted in Western countries, and parallel evidence drawn from Asian populations is even more sparse [4]. Given the limited and inconsistent findings on the relationship between PA and HS in Asian populations, we conducted the present populationbased, longitudinal follow-up study to investigate whether PA is associated with a reduced risk of HS and the optimal level of PA for HS prevention in Taiwan. Data on the relationship between physical activity (PA) and hemorrhagic stroke (HS) are limited in Asian populations.

Methods

Results

Discussion

Conclusion