title: Physical activity and risk of cerebrovascular disease in the European Prospective Investigation into Cancer and Nutrition-Spain study.
abstract: OBJECTIVE
  Large-scale prospective epidemiological data testing the association between physical activity (PA) and cerebrovascular diseases (CVDs) are scarce, particularly in Europe. The objective was to assess the risk of CVD according to PA levels in adults.
  
  
  METHODS
  We included a total of 13 576 men and 19 416 women aged 29 to 69 years and participating in the European Prospective Investigation into Cancer and Nutrition cohort in Spain, recruited between 1992 and 1996 and followed-up until 2006 to ascertain incident CVD events. The validated European Prospective Investigation into Cancer and Nutrition PA questionnaire was used to assess metabolic equivalent × hours per week dedicated to different types of PA. Hazard ratios of CVD by PA levels were estimated using multivariate Cox regression. Extensive baseline data collected on diet, lifestyle habits, medical history, and anthropometry were available to adjust for.
  
  
  RESULTS
  A total of 210 transient ischemic attacks and 442 stroke cases (80% ischemic, 10% hemorrhagic, 7% subarachnoid hemorrhage, and 3% mixed or unspecified) were registered after 12.3 years of mean follow-up. Recreational activity was inversely associated with risk of CVD in women but not in men. Women walking for ≥3.5 hours per week were at lower risk of stroke than those who did not engage in regular walking. No significant associations were found for other leisure time activities or vigorous PA with CVD in either sex.
  
  
  CONCLUSIONS
  Recreational PA of moderate intensity was inversely associated with stroke incidence in women, whereas PA showed no effect on CVD risk in men. Increasing time dedicated to activities such as walking would be expected to help to reduce the stroke burden in women.
authors.affiliation: Consejería de Sanidad y Política Social, Servicio de Epidemiología, Ronda de Levante, 11, 30008, Murcia, Spain. josem.huerta@carm.es
authors.forename: José María
authors.initials: JM
authors.lastname: Huerta
authors.forename: María-Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.forename: María-José
authors.initials: MJ
authors.lastname: Tormo
authors.forename: Diana
authors.initials: D
authors.lastname: Gavrila
authors.forename: Larraitz
authors.initials: L
authors.lastname: Arriola
authors.forename: Conchi
authors.initials: C
authors.lastname: Moreno-Iribas
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Nerea
authors.initials: N
authors.lastname: Egüés
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: María-José
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: Carlos A
authors.initials: CA
authors.lastname: González
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
mesh_terms: D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009369:Neoplasms / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D009749:Nutrition Surveys / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires