Excess Leisure Sedentary Activities Raises Risk of Stroke


Physical activity and its association with a lower risk of stroke have been well-established. Research also supports staying physically active during stroke recovery. In a 2014 scientific statement, the American Heart Association recommended doctors prescribe low- to moderate-intensity aerobic activity, muscle-strengthening activity, reduction of sedentary behavior, and risk management to prevent a second stroke.

On the other hand, previous studies have identified excess sedentary time as a risk factor for cardiovascular disease and death, independent of physical activity. Since sedentary time has increased over the past two decades in the United States and Canada, particularly among the young population, the importance of characterizing its effect on long-term health has also been raised.

Recent research published in the American Stroke Association journal aimed to better understand the risk of sedentary time specific to stroke. They found that adults younger than 60 years old whose days are filled with sedentary leisure time and little physical activity have a higher stroke risk than those who are more physically active.

The Link Between Excess Leisure Sedentary Time and Risk of Stroke 

The internet and social media are now more widely used, especially among older folks. American Heart Association figures show that Americans spend an average of 10.5 hours a day online, whether on their cellphones, laptops, or watching television. Adults aged 50 to 64 spend the most time online of any age group.

Additionally, data show a decline in 2010 in the number of stroke-related deaths among people 65 and older. But among younger persons aged 35 to 64, the fatality rate from stroke appears to be rising, rising from 14.7 per 100,000 adults in 2010 to 15.4 per 100,000 in 2016. According to prior studies, sedentary lifestyles increase an adult’s risk of cardiovascular disease, including stroke, and approximately 9 out of 10 strokes may be caused by risk factors, including sedentary lifestyles.

According to the study, sedentary time refers to the length of awake activities done sitting or lying down. Leisure sedentary time pertains to the sedentary activities done outside work. 

The researchers argued that knowing whether leisure sedentary time can lead to stroke in young individuals is crucial as stroke can cause premature death or significantly affect function and quality of life.

The study examined the health and lifestyle data of 143,000 persons who participated in the Canadian Community Health Survey in the years 2000, 2003, 2005, and 2007 to 2012 and had no history of cancer, heart disease, or stroke. Researchers linked participant data with hospital records to identify strokes throughout an average of 9.4 years (until December 31, 2017).

They looked at how much time was spent each day engaging in leisurely sedentary activities and classified it into four categories: less than four hours, four to less than six hours, six to less than eight hours, and eight hours or more. The level of physical activity was also divided into quartiles, or four equal groups, with the lowest quartile representing the least physical activity and equivalent to daily walking for no more than 10 minutes.

Based on their analysis of the study participants, the researchers found:

  • 2,965 strokes occurred over the follow-up period, which lasted an average of 9.4 years. Most of those strokes—nearly 90%—were ischemic strokes, which occur when a blood vessel supplying the brain is blocked.
  • The total number of participants’ daily leisurely sedentary time was 4.08 hours. The average leisurely idle time for people under 60 was 3.9 hours per day. Adults aged 60 to 79 spent 4.4 hours per day on average inactive leisure, whereas those 80 years and older spent 4.3 hours.
  • Compared to people who reported fewer than four hours of daily leisure sedentary time, adults 60 years of age and younger with poor physical activity who reported eight or more hours of leisure sedentary time a day had a 4.2 times increased risk of stroke.
  • Compared to individuals who reported less than four hours of daily sedentary time and higher levels of physical activity, the most sedentary group—those reporting eight or more hours of sedentary time and poor physical activity—had a seven times higher risk of stroke.

The study’s findings demonstrate that very high sedentary time with little time spent on physical activity can have unfortunate impacts on health, including an elevated risk of stroke. With this, the researchers encourage physician recommendations and public health policies to emphasize the need and importance of increasing physical activity to lessen leisure sedentary time, improve health outcomes, and lower the risk of cardiovascular conditions and stroke.

Journal Reference

Joundi, R. A., Patten, S. B., Williams, J. V. A., & Smith, E. E. (2021). Association between excess leisure sedentary time and risk of stroke in young individuals. Stroke, 52(11), 3562–3568. https://doi.org/10.1161/strokeaha.121.034985 

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