The association of domain-specific physical activity and sedentary activity with stroke: A prospective cohort study

TL;DR

This study found that leisure-time physical activity reduces stroke risk, while sedentary behavior increases it, highlighting the importance of engaging in regular physical activity for cardiovascular health.

Contribution

It uniquely distinguishes the effects of different physical activity domains and sedentary behavior on stroke risk using a large, prospective cohort dataset.

Findings

LTPA reduces stroke risk by 35.7%.

Less than 7.5 hours of sedentary activity lowers stroke risk.

Nonlinear U-shaped relationship between PA intensity and stroke risk.

Abstract

Background The incidence of stroke places a heavy burden on both society and individuals. Activity is closely related to cardiovascular health. This study aimed to investigate the relationship between the varying domains of PA, like occupation-related Physical Activity (OPA), transportation-related Physical Activity (TPA), leisure-time Physical Activity (LTPA), and Sedentary Activity (SA) with stroke. Methods Our analysis included 30,400 participants aged 20+ years from 2007 to 2018 National Health and Nutrition Examination Survey (NHANES). Stroke was identified based on the participant's self-reported diagnoses from previous medical consultations, and PA and SA were self-reported. Multivariable logistic and restricted cubic spline models were used to assess the associations. Results Participants achieving PA guidelines (performing PA more than 150 min/week) were 35.7% less likely to have a stroke based on both the total PA (odds ratio [OR] 0.643, 95% confidence interval [CI] 0.523-0.790) and LTPA (OR 0.643, 95% CI 0.514-0.805), while OPA or TPA did not demonstrate lower stroke risk. Furthermore, participants with less than 7.5 h/day SA levels were 21.6% (OR 0.784, 95% CI 0.665-0.925) less likely to have a stroke. The intensities of total PA and LTPA exhibited nonlinear U-shaped associations with stroke risk. In contrast, those of OPA and TPA showed negative linear associations, while SA intensities were positively linearly correlated with stroke risk. Conclusions LTPA, but not OPA or TPA, was associated with a lower risk of stroke at any amount, suggesting that significant cardiovascular health would benefit from increased PA. Additionally, the positive association between SA and stroke indicated that prolonged sitting was detrimental to cardiovascular health. Overall, increased PA within a reasonable range reduces the risk of stroke, while increased SA elevates it.