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Walking pace and the risk of stroke: A meta-analysis of prospective cohort studies
Authors:Minghui Quan  Pengcheng Xun  Ru Wang  Ka He  Peijie Chen
Institution:1. School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China;2. Department of Epidemiology and Biostatistics, School of Health-Bloomington, Indiana University, Bloomington, IN 47405, USA
Abstract:PurposeThe extent to which walking pace is associated with a reduced risk for stroke remains unclear. This study examined the association between walking pace and stroke risk based on prospective cohort studies.MethodsDatabases of PubMed, EMBASE, Web of Science, Scopus, and China National Knowledge Internet were searched from the inception dates to January 31, 2019, for prospective cohort studies focusing on walking pace and risk of stroke in adults. Two reviewers independently extracted data and assessed the quality of the studies. The dependent measure was stroke incidence. Using random-effects models, a meta-analysis was performed to estimate the overall relative risks (RR) of stroke incidence and 95% confidence intervals (CIs) for the individuals with the fastest walking paces vs. individuals with the slowest walking paces. A dose-response relationship was also examined.ResultsAfter screening 1294 titles/abstracts and 14 full-text studies identified in the search, 7 studies (from 8 cohorts) were included in the meta-analysis. The 7 studies included a total of 135,645 participants (95.2% women; mean age 63.6 years) and 2229 stroke events (median follow-up time = 8.0 years). Compared to individuals in the slowest walking-pace category (median = 1.6 km/h), individuals in the fastest walking-pace category (median = 5.6 km/h) had a 44% lower risk of stroke (pooled RR = 0.56, 95%CI: 0.48–0.65). There was also a linear dose-response relationship (RR = 0.87; 95%CI: 0.83–0.91), with the risk of stroke decreased by 13% for every 1 km/h increment in baseline walking pace. We observed similar results across walking-pace assessment, type of stroke ascertainment, stroke subtypes, sex, sample size, and duration of follow-up.ConclusionFindings from this meta-analysis indicate that walking pace is inversely associated with the risk of stroke.
Keywords:Dose response  Meta-analytic review  Stroke incidence  Walking pace
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