Leisure time, occupational, and commuting physical activity and the risk of stroke

Background and Purpose - The role of physical activity, especially that of occupational and commuting physical activity, in the prediction of stroke risk is not properly established. We assessed the relationship of different types of physical activity with total and type-specific stroke risk. Methods - We prospectively followed 47721 Finnish subjects 25 to 64 years of age without a history of coronary heart disease, stroke, or cancer at baseline. Hazard ratios (HRs) for incident stroke were estimated for different levels of leisure time, occupational, and commuting physical activity. Results - During a mean follow-up of 19.0 years, 2863 incident stroke events were ascertained. The multivariate-adjusted ( age, sex, area, study year, body mass index, systolic blood pressure, cholesterol, education, smoking, alcohol consumption, diabetes, and other 2 types of physical activity) HRs associated with low, moderate, and high leisure time physical activity were 1.00, 0.86, and 0.74 (P-trend < 0.001) for total stroke, 1.00, 0.87, and 0.46 (P-trend = 0.011) for subarachnoid hemorrhage, 1.00, 0.77, and 0.63 (P-trend = 0.024) for intracerebral hemorrhage, and 1.00, 0.87, and 0.80 (P-trend = 0.001) for ischemic stroke, respectively. The multivariate-adjusted HRs associated with none, 1 to 29, and >= 30 minutes of active commuting were 1.00, 0.92, and 0.89 (P-trend = 0.043) for total stroke, and 1.00, 0.93, and 0.86 (P-trend = 0.028) for ischemic stroke, respectively. Occupational activity had a modest association with ischemic stroke in the multivariate analysis (P-trend = 0.046). Conclusion - A high level of leisure time physical activity reduces the risk of all subtypes of stroke. Daily active commuting also reduces the risk of ischemic stroke.