Walking shrinks women's stroke risk

Study: 2 hours a week lowers stroke chance by 30 percent

DALLAS - Women can lower their stroke risk by lacing up their sneakers and walking, a new study suggests.

Women who said they walked briskly had a 37 percent lower risk of stroke than those who didn't walk. Women who reported walking at least two hours a week at any pace had a 30 percent lower risk, according to a study published online Tuesday in the American Heart Association journal Stroke.

While previous studies have shown that physical activity decreases the chances of having a stroke, the new study focused on what kind of exercise might be most beneficial for women.

"This certainly speaks to walking for a certain amount of time and walking briskly as well," said Jacob Sattelmair, lead author of the study and a doctoral student at Harvard School of Public Health in Boston.

Those walking at a brisk pace should be able to talk — but not sing, he said.

The research involved about 39,000 female health workers 45 or older enrolled in the Women's Health Study. The women were periodically asked about their physical activity. During 12 years of follow-up, 579 had strokes.

Besides walking, the study looked at vigorous activities like running, swimming and biking, but researchers didn't find a link between those vigorous activities and a reduced stroke risk. The researcher said there may not have been enough women in that group to show a difference. It's also possible, they said, that moderate activity is better at lowering blood pressure, a strong risk factor for stroke.

The researchers took into account age, aspirin use, smoking and other things that could influence stroke risk.

"I think what's encouraging is that moderate activities are powerfully effective in reducing the risks of stroke," said Dr. Anand Rohatgi, a cardiologist at the University of Texas Southwestern Medical Center in Dallas.

In addition to high blood pressure, risk factors for stroke include heart disease, Type 2 diabetes and obesity.

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"The things that directly correlate with stroke are improved with physical activity," Rohatgi said. "They all line up."

Dr. Tracy Stevens, director of Saint Luke's Muriel I. Kauffman Women's Heart Center in Kansas City, Mo., said people can see the benefits of exercise by taking their blood pressure after exercising to see how much lower it is.

"It takes hard work," she said, adding, "It doesn't have to be anything fancy."

The American Heart Association recommends that adults do 2½ hours a week of moderate-intensity or 75 minutes a week of vigorous aerobic activity or a combination.

 

Call to end exclusion of elderly from drug trials

A charter against ageism in clinical trials is being launched by a group of geriatricians from Europe.

The EU funded project, called PREDICT, says treatments are less likely to be tested on older people even though the elderly take the most medication.

Trial results from younger people cannot always be extrapolated to the elderly, say the authors.

They want older people to have access to drugs which have been shown to be safe and effective for their age group.

PREDICT set out assess the extent to which the elderly were excluded from clinical trials and to come up with solutions.

They surveyed the medical literature on treatments for conditions which were common among elderly people and found clear evidence that the elderly were underrepresented.

For example, the average age of patients in clinical trials of treatments for high blood pressure is 63, although 44% of patients are over 70 when they are first diagnosed.

The researchers interviewed health professionals in nine countries and conducted more than 50 focus groups with elderly people and their carers.

They concluded that both doctors and patients felt that more elderly people should be included in trials.

"If treatments are not evaluated for elderly people it is difficult for doctors to balance the risks and benefits" said Dr Gary Mills, Director of Medical Economics and Research Centre, Sheffield, who is one of the co-ordinators of the project.

'Practical steps'

Dr Mills said people conducting trials may need to take practical steps to help the elderly participate, such as going to their house rather than expecting them to travel.

The British Geriatrics Society welcomed the project. Their spokesman Professor David Oliver said the under-representation of elderly people in clinical trials was a "serious problem".

He said it was easier for drug companies to carry out testing on younger people, but this means the trial group is "not representative" of the majority of taking medicines.

He added that drugs might be more or less effective on the elderly than younger older people, and might have different side effects.

"Doctors try to practise evidence-based medicine, but this is not possible if there are not enough elderly people in the trials."

'Ageism'

Stephen Jackson, Professor of Professor of Clinical Gerontology from King's College, London, said the reasons why not enough elderly people are included in trails go beyond practical difficulties.

"The elderly are underrepresented in clinical trials because of ageism," he said.

He pointed out that elderly people often have more than one condition and that makes it more complicated for those conducting trials to include them.

People conducting trials think it is "too much trouble" to include older people he said. This would not change without regulation, he added.

Age Concern welcomed the initiative. Andrew Harrop their Head of Policy said: "More and more people will be living longer and many with multiple long-term conditions.

"Addressing the shortfall in the numbers of older people taking part in clinical trials is crucial to ensure the well-being of a growing proportion of the population."