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	Since this article does not have an abstract, we have provided the first 98 words of the full text and any section headings.

Dr Kurl and colleagues¹ found a strong inverse relation between cardiorespiratory fitness and risk of stroke in middle-aged men. However, among the plausible explanations of this beneficial effect, they did not mention the anti-inflammatory effect of physical activity.

There is mounting evidence that increasing fitness levels are associated with reduced levels of C-reactive protein, a sensitive marker of systemic inflammation.^2-3 Since elevated levels of this marker seem to be related to an increased risk of stroke,^4-5 the association between cardiorespiratory fitness and a reduced risk of stroke might also be mediated by the anti-inflammatory effects of physical activity.

Luca Mascitelli, MD
Udine, Italy

Francesca Pezzetta, MD
Gemona del Friuli, Italy

1. Kurl S, Laukkanen JA, Rauramaa R, Lakka TA, Sivenius J, Salonen JT. Cardiorespiratory fitness and the risk of stroke in men. Arch Intern Med. 2003;163:1682-1688. FREE FULL TEXT 2. Ford ES. Does exercise reduce inflammation? physical activity and C-reactive protein among US adults. Epidemiology. 2002;13:561-568. FULL TEXT | ISI | PUBMED 3. Church TS, Barlow CE, Earnest CP, Kampert JB, Priest EL, Blair SN. Associations between cardiorespiratory fitness and C-reactive protein in men. Arterioscler Thromb Vasc Biol. 2002;22:1869-1876. FREE FULL TEXT 4. Rost NS, Wolf PA, Kase CS, et al. Plasma concentration of C-reactive protein and risk of ischemic stroke and transient ischemic attack: the Framingham Study. Stroke. 2001;32:2575-2579. FREE FULL TEXT 5. Curb JD, Abbott RD, Rodriguez BL, et al. C-reactive protein and the future risk of thromboembolic stroke in healthy men. Circulation. 2003;107:2016-2020. FREE FULL TEXT

Arch Intern Med. 2004;164:460.

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