Abstract P040: The Protective Effect of Faster Walking Pace on Risk of Stroke in Older Men
Introduction: Stroke is a major cause of disability and mortality at older ages, making preventive strategies important. Epidemiologic data from middle age suggest that physical activity protects against stroke. Older adults have lower levels of overall and moderate to vigorous physical activity than younger adults. Walking is a predominant form of physical activity in older adults. We therefore study prospective associations between walking pace, duration and other physical activity in later adult life and risk of stroke incidence, and the mediating role of established CVD risk factors.
Methods: In 1998-2000, 4252 men from a UK population-based cohort self-reported usual PA (regular walking duration and pace, cycling, recreational activity and sport), alongside other health behaviors and medical history (77%[4252/5522] response rate). Nurses took fasting blood samples and measured blood pressure, height and weight.
Results: In 1998-2000, 3008 men aged 68.3(SD 5.5) years were free from CVD and diabetes and not confined to a wheelchair. 93% (2796/3008) reported complete physical activity data. During a median 10.9 years follow-up, 183 first stroke events occurred among 2796 men, 6.7(95%CI 5.8, 7.8) per 1000 person-years . Men reported distance walked (miles/week); 25% (693/2796) men reported walking<=3, 28%(785/2796) 4-7, 28%(784/2796) 8-14 and 19%(534/2796)>=15 miles/week. Men reported walking pace as slow (12%, 326/2796), steady average (64%, 1788/2796) and “fairly brisk or fast” (24%, 682/2796). Men who walked at a faster pace walked further X2 =241(6 degrees of freedom), p<0.001. Compared to men walking <=3 miles/week, Hazard Ratios (95%CIs) for first stroke risk by distance walked were 0.98 (0.65,1.48), 1.04 (0.69,1.56), 0.66 (0.40,1.11), p(linear trend)=0.9, and were little changed on adjustment for established risk factors (social position, alcohol and tobacco use, systolic and diastolic blood pressure, body mass index, triglycerides and cholesterol (total and HDL)), walking pace and vigorous physical activity. Compared to men with slow walking pace, Hazard Ratios (95%CIs) for first stroke for “steady” and “brisk/fast”, adjusted for age and region were 0.66 (0.44, 1.00) and 0.57 (0.34, 0.96), p(linear trend)=0.03. Estimates were very similar after adjustment for (i) established risk factors, (ii) distance walked and (iii) vigorous activity; 0.66 (0.42, 1.03) and 0.62 (0.35, 1.08), p(linear trend)=0.1.
Discussion: Faster walking pace was associated with reduced risk of onset of stroke, independent of established risk factors and distance walked. Walking, particularly at moderate or fast pace, could form an important part of stroke-prevention strategies. Future studies using accelerometers will shed more light on this question.
- © 2013 by American Heart Association, Inc.