Key result
Smoking cessation plus regular exercise is linked to ~80% lower 13-year mortality.
Why the study?
The role of smoking cessation, regular physical exercise and/or physical activity on survival and cardiovascular risk prediction in the Indonesian population was not well established.
Does smoking cessation combined with regular physical exercise and/or physical activity improve survival in an Indonesian population?
Cohort (n=479)
Yes
Does smoking cessation combined with regular physical exercise and/or physical activity improve survival in an Indonesian population?
Hazard Ratio: 0.2 (95% CI 0.08–0.57)
Absolute Event Rate: 95.7% vs 81.1%
p-value: p=0.002
Smoking cessation and regular physical activity significantly improve 13-year survival and reduce cardiovascular mortality in an Indonesian cohort.
SOK adherence was associated with higher survival in this Indonesian cohort; supports community prevention but leaves causal confirmation open.
Preventing atherosclerosis with smoking cessation, regular physical exercise and/or physical activity known as SOK (S-top/ no S-moking, sp-O-rt/ physical exercise, wor-K/ physical activity) is a simple preventive measure, which can be applied in the community. To determine the role of SOK on survival, to create cardiovascular risk score for Indonesian patients and to have a special formula to predict survival. A historical cohort study over thirteen years recruited from the subpopulation MONICA patients who resided at three districts of South Jakarta. Patients were divided into two groups, those with SOK and those without (non-SOK group). Assessment included complete history including cardiovascular risk factors (hypertension, diabetic, hyperlipidemia, obesity), physical examination, laboratory examination, twelve-lead ECG recording and level of physical activity/exercise. Outcomes included survival rate and all-cause of mortality. Statistical analysis included kappa statistic and various survival analyses. 479 participants were included in the SOK study. Mean age 46 years (range 25-64), 56% female. Cardiovascular mortality rate (including stroke) was 1.2% per year and 42.9% of mortality caused by heart disease. Survival rate was higher in SOK group compared with non-SOK (95.7% vs 81.1%) with Hazard Ratio (HR) 0.2 for SOK group (95% CI 0.08-0.57, p=0.002) In relation to the cardiovascular mortality rate: 1) any physical activity/exercise (OK) vs no-OK will lower the risk; low-OK (HR 0.4, p=0.003), medium-OK (HR 0.32, p=0.004), high-OK (HR 0.000, p=0.000) 2) Smoking will increase the risk vs non-smoking (HR 4.99, p=0,000). For predicting the cardiovascular events in ten-year time (CV10), we formulated the Jakarta Cardiovascular Score. The score was divided into low-risk (-7-1) with CV10 <10%, average-risk (2-4) with CV10 = 10-20%, high-risk (score > 5) with CV10 >20%. Smoking cessation, regular physical exercise and/or physical activity is an effective method to reduce cardiovascular death, thus enhances the survival. We formulated a simple method to predict cardiovascular events in our community known as the Jakarta Cardiovascular Score. (Med J Indones 2002; 11: 230-41)
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Dede Kusmana (2002) conducted a cohort in Atherosclerosis prevention (n=479). SOK (smoking cessation, regular physical exercise and/or physical activity) vs. non-SOK group was evaluated on survival rate (HR 0.2, 95% CI 0.08-0.57, p=0.002). Smoking cessation and regular physical activity (SOK) significantly improved 13-year survival compared to no SOK (95.7% vs 81.1%; HR 0.2; 95% CI 0.08-0.57; p=0.002).
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