What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease (n=837). Intervention: Sports activity (≥20 min/week). Primary outcome: All-cause mortality (HR 0.32, 95% CI 0.16-0.65).

April 1, 2009Open Access

Physical activity and mortality in men and women with diagnosed cardiovascular disease

Key Result

Participating in at least 20 min/week of sports activity was associated with a significantly lower risk of all-cause mortality in patients with established CVD (HR 0.32; 95% CI 0.16-0.65).

Study Design

Type

Cohort (n=837)

Structured PICO

Does at least 20 min/week of sports activity or walking reduce all-cause mortality in men and women with diagnosed cardiovascular disease?

Population

837 men and women with clinically confirmed cardiovascular disease, followed for an average of 5.6 years.

Exposure

At least 20 min/week of sports activity or walking

Comparator

Lower levels of physical activity (implied)

Outcome

All-cause mortalityhard clinical

In patients with established CVD, engaging in at least 20 minutes per week of moderate-to-vigorous physical activity is associated with a substantial reduction in all-cause mortality.

Main Result

Hazard Ratio: 0.32 (95% CI 0.16–0.65)

Abstract

BACKGROUND: Existing information regarding the optimal types and amount of physical activity for secondary prevention is controversial. We examined the association between different types of physical activity (domestic, walking, sports) and mortality in participants with established cardiovascular disease (CVD). METHODS: Data were collected from the Scottish Health Surveys (1995, 1998, 2003) that were linked to a patient-based database of CVD hospital admissions and deaths. There were 837 men and women with clinically confirmed CVD at baseline, of whom 175 died over an average of 5.6+/-3.1 years of follow-up. RESULTS: The lowest risks for all-cause mortality were seen in participants undertaking at least 20 min/week of sports activity (fully adjusted hazard ratio=0.32, 95% confidence interval=0.16-0.65) or walking (hazard ratio=0.74, 0.53-1.04). Similar associations were observed for CVD mortality. The physically active also showed lower levels of inflammatory risk markers and greater HDL cholesterol. CONCLUSION: Men and women with existing CVD who participate in moderate-to-vigorous activity for at least 20 min/week showed the lowest risks of all-cause and cardiovascular mortality. These findings support emerging data from controlled exercise training studies.