Key result
Higher levels of physical activity were inversely associated with incident CHD risk, with men expending ≥12,600 kJ/wk having a relative risk of 0.81 compared to those expending <2,100 kJ/wk (P for trend=0.003).
Why the study?
Does higher quantity and intensity of physical activity reduce the risk of incident CHD in middle-aged and older men?
Cohort (n=12,516)
Does higher quantity and intensity of physical activity reduce the risk of incident CHD in middle-aged and older men?
Total physical activity and vigorous activities are inversely associated with the risk of incident coronary heart disease in middle-aged and older men, even among those with multiple coronary risk factors.
Supports observational link of higher activity with lower CHD risk in men; leaves open causality and need for trials before practice change.
BACKGROUND: The quantity and intensity of physical activity required for the primary prevention of coronary heart disease (CHD) remain unclear. Therefore, we examined the association of the quantity and intensity of physical activity with CHD risk and the impact of other coronary risk factors. METHODS AND RESULTS: We followed 12 516 middle-aged and older men (mean age 57.7 years, range 39 to 88 years) from 1977 through 1993. Physical activity was assessed at baseline in kilojoules per week (4.2 kJ=1 kcal) from blocks walked, flights climbed, and participation in sports or recreational activities. During follow-up, 2,135 cases of incident CHD, including myocardial infarction, angina pectoris, revascularization, and coronary death, occurred. Compared with men expending <2,100 kJ/wk, men expending 2,100 to 4,199, 4,200 to 8,399, 8,400 to 12,599, and >/=12,600 kJ/wk had multivariate relative risks of 0.90, 0.81, 0.80, and 0.81, respectively (P: for trend=0.003). When we considered the independent effects of specific physical activity components, only total sports or recreational activities (P: for trend=0.042) and vigorous activities (P: for trend=0.02) were inversely associated with the risk of CHD. These associations did not differ within subgroups of men defined by coronary risk factors. Finally, among men with multiple coronary risk factors, those expending >/=4,200 kJ/wk had reduced CHD risk compared with men expending <4,200 kJ/wk. CONCLUSIONS: Total physical activity and vigorous activities showed the strongest reductions in CHD risk. Moderate and light activities, which may be less precisely measured, showed nonsignificant inverse associations. The association between physical activity and a reduced risk of CHD also extends to men with multiple coronary risk factors.
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Sesso et al. (2000) conducted a cohort in Coronary Heart Disease (n=12,516). Physical activity vs. <2,100 kJ/wk was evaluated on Incident CHD (myocardial infarction, angina pectoris, revascularization, and coronary death) (RR 0.81, p=0.003). Higher levels of physical activity were inversely associated with incident CHD risk, with men expending ≥12,600 kJ/wk having a relative risk of 0.81 compared to those expending <2,100 kJ/wk (P for trend=0.003).
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