Staying or becoming fit significantly reduced risks in long-term follow-up of healthy middle-aged men.
Numerous studies have examined how lifestyle factors influence the risk for stroke. Whereas much attention has been given to smoking cessation, there is now an enhanced appreciation for the potential value of optimal diet and physical activity.
To determine how changes in fitness over time affect long-term risks for stroke and death, investigators for the Oslo Ischemia Study analyzed 1403 healthy men who were between 40 and 59 years of age in 1972 to 1975. Subjects were assessed for cardiovascular (CV) fitness with a bicycle electrocardiogram (ECG) test at baseline and at 7 years. Subjects were classified as remained fit, became unfit, remained unfit, or became fit. The ECG test defined CV fitness as cumulative energy expenditure per body weight and adjusted for age.
At a mean follow-up duration was 23.6 years, results were as follows:
- Among participants who were fit at baseline, those who became unfit at follow-up had significantly higher risks for ischemic stroke and death than those who remained fit at follow-up (hazard ratio, 2.35 and 1.74, respectively); in absolute terms, becoming unfit increased stroke by 6.8%.
- Among participants who were unfit at baseline, those who became fit at follow-up had significantly lower risks for ischemic stroke and death than those who remained unfit at follow-up (HR, 0.40 and 0.66, respectively); in absolute terms, becoming fit reduced stroke by 7.3%.
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