BMJ  1993;307:231-234 (24 July), doi:10.1136/bmj.307.6898.231

Lifelong exercise and stroke.

University of Birmingham, Department of Medicine, Dudley Road Hospital.

OBJECTIVES--To examine the potential of lifelong patterns of increased physical activity to prevent stroke. DESIGN--Case-control study. SETTING--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 controls frequency matched for age and sex recruited over 24 months during 1988-90. Exclusion criteria were a previous history of stroke, mitral valvular heart disease combined with atrial fibrillation, primary or metastatic cerebral neoplasm, or coagulation disorder or myeloproliferative disease. MAIN OUTCOME MEASURES--Odds ratios for stroke related to lifetime history of exercise after 15 years of age. RESULTS--A history of vigorous exercise during the ages 15-25 appeared to protect from stroke: 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 factors. Increasing years of participation in vigorous exercise between the 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 ischaemia, peripheral vascular disease, and poor health recent vigorous exercise 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 recent walking. CONCLUSIONS--Appreciable protection from stroke in later life is conferred by vigorous exercise in early adulthood. This increased level of physical activity should, if possible, be continued lifelong.

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