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Physical activity decreases the risk of stroke in middle-age men with left ventricular hypertrophy: 40-year follow-up (1961–2001) of the Seven Countries Study (the Corfu cohort)


Left ventricular hypertrophy (LVH) is a dominant characteristic of cardiovascular mortality. We investigated the interaction between physical activity and LVH on stroke mortality, based on a 40-year follow-up of the Corfu cohort from the Seven Countries Study. The population studied consisted of 529 rural men (40–59 years old) enrolled in the Study at 1961. LVH was electrographically confirmed according to Minnesota coding. Physical activity levels were assessed by self-reports of habitual, occupational and leisure-time activities. Cox proportional hazard models were used to evaluate exercise levels with respect to stroke mortality in people with and without LVH. During the follow-up, 461 (87%) died, and 74 (16%) of these deaths were due to stroke. LVH was present in 40 (7.5%) men. A total of 362 (68%) men were defined as physically active. Physical activity was associated with a lower risk of stroke (hazard ratio=0.65, P<0.05). On the other hand, LVH had 5.8-fold the risk of stroke (P<0.001) among sedentary and 4.5-fold the risk (P<0.001) among physically active men, after controlling for several potential confounders. However, moderate physical activity decreased the risk of stroke by 49% in men with LVH as compared to sedentary without LVH (hazard ratio=0.51, P<0.01), while hard exercise did not confer any significant reduction in stroke risk. We revealed the benefits from moderate physical activity on stroke mortality among men with LVH. Physicians and other health-care professionals should encourage patients with LVH to adopt a physically active lifestyle.

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We are grateful to Dr Dia Pitsavos, Mrs Klio Dontas and Dr Anastasia Katinioti for their substantial assistance during the 40 years follow-up. We are grateful particularly to the men of the villages of Corfu whose cooperation made this follow-up study feasible. Also, we thank the mayors of the villages, the register of the city of Corfu, the director and the staff of the San Marcos Medical Center as well as the microbiological laboratory of the Corfu's Prefectorial Hospital for their substantial support at the follow-up.

The Seven Countries Study was funded by Grants HE 04697, HE 6090 and HE00278 from the National Heart, Lung and Blood Institute.

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Correspondence to D B Panagiotakos.

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Pitsavos, C., Panagiotakos, D., Chrysohoou, C. et al. Physical activity decreases the risk of stroke in middle-age men with left ventricular hypertrophy: 40-year follow-up (1961–2001) of the Seven Countries Study (the Corfu cohort). J Hum Hypertens 18, 495–501 (2004).

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  • physical activity
  • stroke
  • left ventricular hypertrophy


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