High cardiorespiratory fitness in middle age reduces stroke risk later

Adults aged 45 to 50 years with high cardiorespiratory fitness have up to a 37% reduced risk for stroke after age 65 years, independent of other traditional stroke risk factors, according to study findings published in Stroke.

“We all hear that exercise is good for you, but many people don’t do it,” Ambarish Pandey, MD, cardiology fellow, University of Texas Southwestern Medical Center, Dallas, said in a press release. “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.”

Ambarish Pandey

The researchers paired data from the Cooper Center Longitudinal Study with Medicare claims files to analyze 19,815 adults aged 45 to 50 years at baseline (79% men, 90% white) from 1999 to 2009. The Cooper study gauged heart and lung exercise capacity on a treadmill, and stratified participants by high, middle or low levels of cardiorespiratory fitness, organizing them into age- and sex-adjusted quintiles.

From the Cooper cohort, 808 participants were hospitalized for stroke after age 65 years across 129,436 person-years of Medicare-eligible follow-up. The researchers found higher midlife cardiorespiratory fitness conferred lower risk for stroke hospitalization (HR for two most-fit quintiles vs. least-fit quintile = 0.61; 95% CI, 0.49-0.76). The results were unchanged when adjusting for Medicare-identified risk factors for stroke: hypertension, diabetes and atrial fibrillation (HR for two most-fit quintiles vs. least-fit quintile = 0.63; 95% CI, 0.51-0.79).

“Low fitness is generally ignored as an actual risk factor in clinical practice,” Pandey said in the press release. “Our research suggests that low fitness in midlife is an additional risk to target and help prevent stroke later in life.”

The researchers noted some limitations of the study: The participants were well-educated and had access to preventive health care, as well as a low rate of traditional stroke risk factors. Also, stroke hospitalizations happening after study enrollment but before onset of Medicare eligibility were not counted.

According to the American Heart Association, stroke is the fifth leading cause of death in the United States. – by James Clark

Disclosure: The researchers report no relevant financial disclosures.

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