Physical Activity in Midlife May Prevent Stroke Later

Exercise in midlife can ward off stroke independent of other risk factors, according to a recent study.

An inverse relationship between cardiorespiratory fitness (CRF) and stroke risk was established by previous research, but the mechanism behind this association hadn’t been identified. Meanwhile, the link between CRF and stroke risk hadn’t been isolated from other risk factors that can be modified by physical exercise, such as diabetes, hypertension, and atrial fibrillation.

A recent study published inStrokeevaluated nearly 20,000 adults aged 45 to 50 years to determine their level of fitness by measuring their heart and lung exercise capacity using a treadmill. Participants were then categorized as having high, middle, or low level of fitness.

Those who were the most fit in their mid- to late 40s had a 37% lower risk of stroke than their less fit counterparts. This observed inverse relationship between fitness and stroke risk persisted even after researchers controlled for stroke risk factors, such as high blood pressure, type 2 diabetes, and atrial fibrillation.

“We all hear that exercise is good for you, but many people still don’t do it. Our hope is that this objective data on preventing a fatal disease, such as stroke, will help motivate people to get moving and get fit,” said study author Ambarish Pandey, MD, a cardiology fellow at the University of Texas Southwestern Medical Center, in a press release. “Low fitness is generally ignored as an actual risk factor in clinical practice, [but] our research suggests that low fitness in midlife is an additional risk to target and help prevent stroke later in life.”

Stroke is a leading cause of death and disability in the United States, accounting for about 1 in 20 deaths. The American Heart Association (AHA) estimates that 80% of strokes are preventable by reducing risk factors, such as high blood pressure, high cholesterol, cigarette smoking, poor diet, physical inactivity, and obesity.

Clinicians should encourage their at-risk patients to discuss their exercise goals to ensure that they don’t overexert themselves or put themselves at risk for adverse health events. For patients deemed healthy enough, however, the AHA recommends 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week to reduce the risk of stroke and other cardiovascular issues. In particular, clinicians can advise patients that their exercise regimen should include a combination of aerobic activity (such as walking, swimming, jogging, or biking) and strength training (such as free weights, resistance bands, or gym machines).