Occupational and leisure-time physical activity differentially predict 6-year incidence of stroke and transient ischemic attack in women

• Published in: Scandinavian journal of work, environment & health Vol. 45; no. 3; pp. 267 - 279
• Main Authors: Hall, Clinton, Heck, Julia E, Sandler, Dale P, Ritz, Beate, Chen, Honglei, Krause, Niklas
• Format: Journal Article
• Language: English
• Published: Finland Finnish Institute of Occupational Health 01-05-2019; Scandinavian Journal of Work, Environment & Health; Nordic Association of Occupational Safety and Health (NOROSH)
• Subjects: Cardiovascular disease; Cardiovascular diseases; cerebrovascular disease; Cerebrovascular diseases; cohort; Confidence intervals; Disease control; Employment - statistics & numerical data; Epidemiology; Exercise; Female; Health risk assessment; Health risks; Heart diseases; Humans; Incidence; Interviews as Topic; Ischemia; Ischemic Attack, Transient - epidemiology; ischemic heart disease; Leisure Activities; leisure-time physical activity; Longitudinal Studies; Middle Aged; Mortality; Occupational Health; occupational physical activity; Original article; Paradoxes; Physical activity; physical activity health paradox; prospective; Prospective Studies; Risk; Risk Factors; Sedentary Behavior; Self Report; Statistical models; Stroke; Stroke - epidemiology; Surveys and Questionnaires; Time Factors; Transient ischemic attack; United States - epidemiology; women; Womens health; work posture; United States; New York; United States > US
• ISSN: 0355-3140; 1795-990X
• DOI: 10.5271/sjweh.3787

Objectives Recent meta-analyses suggest a physical activity health paradox: high levels of occupational physical activity (OPA) increase cardiovascular disease (CVD) risk, while leisure-time physical activity (LTPA) decreases risk. However, studies of women and cerebrovascular disease are limited. This report examines physical activity effects on stroke and transient ischemic attack (TIA) among working women in the United States. Methods OPA history, health status, and lifestyle were assessed by baseline interviews of 31 270 employed Sister Study participants aged 35-74 years. OPA was assessed at six intensity levels (lowest: "mostly sitting"); the highest three were combined as "high intensity work." Independent OPA and LTPA effects on 6-year cerebrovascular disease incidence were estimated in adjusted Cox proportional hazard models. Results Stroke (N=441) and TIA (N=274) risk increased with more standing and higher intensity work at current and longest held job. Compared with mostly sitting, high intensity work at the current job increased TIA risk by 57% [hazard ratio (HR) 1.57, 95% confidence interval (CI) 1.04-2.38]. High intensity OPA at the longest held job increased risk for stroke by 44% (HR 1.44; 95% CI 1.08-1.93). Among women with CVD, sitting and standing equally, especially at the current job, increased risks up to two-fold (TIA HR 1.98, 95% CI 1.10-3.55) compared with mostly sitting at work. LTPA showed inverse associations. Conclusions Higher intensity levels of OPA increased stroke and TIA risks, while LTPA decreased risks; results corroborate the physical activity health paradox for women and cerebrovascular disease. More standing at work increased cerebrovascular disease risks, especially for women with CVD.