Association between estimated cardiorespiratory fitness trajectory and stroke and its subtypes: A prospective cohort study

Abstract

Background and aims

The association between estimated cardiorespiratory fitness (eCRF) and stroke is ethnically heterogeneous, and conclusions are inconsistent among different stroke subtypes. The aim was to examine the relationship between eCRF trajectory and stroke and its subtypes in the Chinese population.

Methods and results

37,881 participants from the Kailuan Study (2006–2021) who underwent three waves survey and were free of cancer and stroke before or during 2010 were included in this study. The main outcome was stroke, involving ischemic stroke (IS) and intracerebral hemorrhage (ICH). The relationships were assessed using the Cox proportional hazard model. Three distinct eCRF trajectories were identified during 2006–2010: low, moderate, and high. A total of 2150 stroke events, including 1944 cases of IS and 231 cases of ICH, were reported during a median follow-up of 11.04 (interquartile range: 10.65–11.33) years. Compared to the low eCRF trajectory group, participants in the high eCRF trajectory group were associated with a 31 % lower risk of stroke (hazard ratio [HR] [95 % CI], 0.69 [0.60–0.81]), a 30 % lower risk of IS (0.70 [0.59–0.82]), and a 43 % lower risk of ICH (0.57 [0.36–0.91]). Notably, the association between the high eCRF trajectory and IS (P _interaction = 0.0270) was stronger among women than men.

Conclusion

A long-term high eCRF level is associated with a decreased risk of stroke, especially ICH. Therefore, achieving or sustaining a high eCRF level over time could be a beneficial strategy for decreasing the risk of stroke.