I was fit beyond belief, but because my Dad's doctor did not warn him to have his children tested after he was found to have 80% carotid blockage, I had a stroke. I blame the medical establishment for my stroke. But then if it didn't happen I would still be leading a life of quiet desperation.
Long-Term Follow-Up of Healthy Middle-Aged Men
Originally published10 Dec 2018Stroke. 2018;0:STROKEAHA.118.021798
Abstract
Background and Purpose—
Low
cardiorespiratory fitness is associated with increased risk of
cardiovascular disease. The present study aims to assess whether change
of fitness over time has any impact on long-term risk of stroke and
death.
Methods—
We
recruited healthy men aged 40 to 59 years in 1972 to 1975, and followed
them until 2007. Physical fitness was assessed with a bicycle ECG test
at baseline and again at 7 years, by dividing the total exercise work by
body weight. Participants were categorized as remained fit, became
unfit, remained unfit, or became fit, depending on whether fitness
remained or crossed the median values from baseline to the 7-year visit.
Outcome data were collected up to 35 years, from study visits, hospital
records, and the National Cause of Death Registry. Risks of stroke and
death were estimated by Cox regression analyses and expressed as hazard
ratios (HRs) with 95% CIs.
Results—
Of
2 014 participants, 1 403 were assessed both at baseline and again at 7
years, and were followed for a mean of 23.6 years. Compared with the
became unfit group, risk of stroke was 0.85 (0.54–1.36) for the remained
unfit, 0.43 (0.28–0.67) for the remained fit, and 0.34 (0.17–0.67) for
the became fit group. For all-cause death, risks were 0.99 (0.76–1.29),
0.57 (0.45–0.74), and 0.65 (0.46–0.90), respectively. Among those with
high fitness at baseline, the became unfit group had a significantly
higher risk of stroke (HR, 2.35; CI, 1.49–3.63) and death (HR, 1.74; CI,
1.35–2.23) than those who remained fit. Among those who had low fitness
at baseline, the became fit group had a significantly lower risk of
stroke (HR, 0.40; CI, 0.21–0.72) and death (HR, 0.66; CI, 0.50–0.85)
than participants in the remained unfit group.
Conclusions—
Cardiorespiratory
fitness at baseline and change in fitness was associated with large
changes in long-term risk of stroke and death. These findings support
the encouragement of regular exercise as a stroke prevention strategy.
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