In patients with stable coronary heart disease, doubling exercise volume was associated with lower all-cause mortality (adjusted HR 0.90; 95% CI 0.87-0.93).
Cohort (n=15,486)
Yes
Does increased physical activity reduce mortality in patients with stable coronary heart disease?
Increased physical activity is associated with a graded decrease in all-cause and cardiovascular mortality in patients with stable coronary heart disease, with the greatest benefit seen in sedentary and high-risk patients.
Hazard Ratio: 0.9 (95% CI 0.87–0.93)
BACKGROUND: Recommendations for physical activity in patients with stable coronary heart disease (CHD) are based on modest evidence. OBJECTIVES: The authors analyzed the association between self-reported exercise and mortality in patients with stable CHD. METHODS: A total of 15,486 patients from 39 countries with stable CHD who participated in the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) study completed questions at baseline on hours spent each week taking mild, moderate, and vigorous exercise. Associations between the volume of habitual exercise in metabolic equivalents of task hours/week and adverse outcomes during a median follow-up of 3.7 years were evaluated. RESULTS: A graded decrease in mortality occurred with increased habitual exercise that was steeper at lower compared with higher exercise levels. Doubling exercise volume was associated with lower all-cause mortality (unadjusted hazard ratio HR: 0.82; 95% confidence interval CI: 0.79 to 0.85; adjusting for covariates, HR: 0.90; 95% CI: 0.87 to 0.93). These associations were similar for cardiovascular mortality (unadjusted HR: 0.83; 95% CI: 0.80 to 0.87; adjusted HR: 0.92; 95% CI: 0.88 to 0.96), but myocardial infarction and stroke were not associated with exercise volume after adjusting for covariates. The association between decrease in mortality and greater physical activity was stronger in the subgroup of patients at higher risk estimated by the ABC-CHD (Age, Biomarkers, Clinical-Coronary Heart Disease) risk score (p for interaction = 0.0007). CONCLUSIONS: In patients with stable CHD, more physical activity was associated with lower mortality. The largest benefits occurred between sedentary patient groups and between those with the highest mortality risk.
“In our study, regular exercise had a large impact on the risk of death in people with coronary heart disease. The greatest benefits of increasing physical activity were in persons who take little or no exercise.”
Stewart et al. (2017) conducted a cohort in stable coronary heart disease (n=15,486). Habitual exercise volume vs. Lower exercise levels was evaluated on all-cause mortality (HR 0.90, 95% CI 0.87-0.93). In patients with stable coronary heart disease, doubling exercise volume was associated with lower all-cause mortality (adjusted HR 0.90; 95% CI 0.87-0.93).