title: Leisure time, occupational, and commuting physical activity and the risk of stroke.
abstract: OBJECTIVE
  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 47 721 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 (Ptrend<0.001) for total stroke, 1.00, 0.87, and 0.46 (Ptrend=0.011) for subarachnoid hemorrhage, 1.00, 0.77, and 0.63 (Ptrend=0.024) for intracerebral hemorrhage, and 1.00, 0.87, and 0.80 (Ptrend=0.001) for ischemic stroke, respectively. The multivariate-adjusted HRs associated with none, 1 to 29, and > or =30 minutes of active commuting were 1.00, 0.92, and 0.89 (Ptrend=0.043) for total stroke, and 1.00, 0.93, and 0.86 (Ptrend=0.028) for ischemic stroke, respectively. Occupational activity had a modest association with ischemic stroke in the multivariate analysis (Ptrend=0.046).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland. hu.gang@ktl.fi
authors.forename: Gang
authors.initials: G
authors.lastname: Hu
authors.forename: Cinzia
authors.initials: C
authors.lastname: Sarti
authors.forename: Pekka
authors.initials: P
authors.lastname: Jousilahti
authors.forename: Karri
authors.initials: K
authors.lastname: Silventoinen
authors.forename: Noël C
authors.initials: NC
authors.lastname: Barengo
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology; D015444:Exercise; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007899:Leisure Activities; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D009790:Occupations; D016016:Proportional Hazards Models; D012063:Relaxation; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology; D011795:Surveys and Questionnaires; D013995:Time; D013997:Time Factors; D014186:Transportation; D016896:Treatment Outcome