The associations between cardiovascular health, physical activity, and menopausal status in pre- and post-menopausal females living with stroke and transient ischemic attack: a cross-sectional analysis of baseline data from the Canadian Longitudinal

In females, menopause reduces estrogen and its cardioprotective effects, doubling cardiovascular disease risk, and nearly doubling stroke risk within 10 years post-menopause. Poor cardiovascular health markers are common post-stroke, increasing recurrent stroke risk. Physical activity improves cardiovascular health in postmenopausal females and post-stroke individuals, yet no studies have explored its relationship with cardiovascular health and menopausal status in females post-stroke. This study investigated (1) the association between physical activity and cardiovascular health in females with stroke and (2) the moderating role of menopausal status on this association. Baseline data from the Canadian Longitudinal Study on Aging were analyzed, including females with stroke who provided menopausal status, self-reported physical activity, cardiovascular outcomes, and covariates. Generalized linear models with analytic weights assessed associations between cardiovascular health measures and physical activity, controlling for age, and smoking history. Subsequent models evaluated the interaction between physical activity and menopausal status. Among 1468 females with stroke (<i>n</i> = 103 (7%) pre- or perimenopausal females), physical activity was beneficially associated with reductions in systolic blood pressure (ß = -0.02, <i>p</i> = 0.04), waist circumference (ß = -0.03, <i>p</i> < 0.01), waist-to-hip ratio (ß = -0.00009, <i>p</i> = 0.03), and C-Reactive protein (ß = -0.007, <i>p</i> < 0.02). There were no significant interactions between physical activity and menopausal status for all outcomes. Physical activity positively impacts cardiovascular health in females with stroke, irrespective of menopausal status. This study lays groundwork for longitudinal research examining cardiovascular differences between pre- and postmenopausal females with stroke.