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June 2, 1994New England Journal of Medicine802 citations

Relation of Leisure-Time Physical Activity and Cardiorespiratory Fitness to the Risk of Acute Myocardial Infarction in Men

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TLTimo A. LakkaJVJuha M. VenäläinenRRRainer Rauramaa

Key Result

Highest levels of leisure-time physical activity significantly reduced the risk of acute myocardial infarction compared to the lowest levels (HR 0.34; 95% CI 0.12-0.94; P=0.04).

Key Points

  • To evaluate the independent associations of leisure-time physical activity and cardiorespiratory fitness, measured by maximal oxygen uptake, with the risk of acute myocardial infarction.
  • Assessed baseline physical activity via quantitative questionnaire and measured maximal oxygen uptake directly through exercise testing in 1453 men aged 42 to 60 years without prior cardiovascular disease or cancer from 1984 to 1989.
  • Followed 1166 men with normal baseline electrocardiograms over an average follow-up period of 4.9 years to monitor incident acute myocardial infarctions.
  • Men in the highest tertile of leisure-time physical activity (>2.2 hours/week) had a lower risk of acute myocardial infarction compared with the lowest tertile after controlling for up to 17 confounders (relative hazard 0.34; 95% CI, 0.12 to 0.94; P=0.04).
  • Men in the highest tertile of maximal oxygen uptake (>2.7 L/min) showed a significantly reduced risk compared with the lowest tertile after multivariable adjustment (relative hazard 0.35; 95% CI, 0.13 to 0.92; P=0.03).

Study Design

Type

Cohort (n=1,453)

Structured PICO

Do higher levels of leisure-time physical activity and cardiorespiratory fitness reduce the risk of acute myocardial infarction in middle-aged men without prior cardiovascular disease?

P
Population
1453 men aged 42 to 60 years who did not report having cardiovascular disease or cancer at baseline (1166 with normal electrocardiograms included in follow-up analysis)
I
Intervention
Highest third of leisure-time physical activity (> 2.2 hours per week) and maximal oxygen uptake (> 2.7 liters per minute)
C
Comparator
Lowest third of leisure-time physical activity and maximal oxygen uptake
O
Outcome
First acute myocardial infarctionhard clinical

Higher levels of leisure-time physical activity and cardiorespiratory fitness are independently associated with a significantly reduced risk of acute myocardial infarction in middle-aged men.

Main Result

Effect estimate: HR 0.34 (95% CI 0.12-0.94)

p-value: p=0.04

Abstract

BACKGROUND: Previous studies have suggested that higher levels of regular physical activity and cardiorespiratory fitness are associated with a reduced risk of coronary heart disease. We investigated the independent associations of physical activity during leisure time and maximal oxygen uptake (a measure of cardiorespiratory fitness) with the risk of acute myocardial infarction. METHODS: During the period 1984 to 1989, we performed base-line examinations in 1453 men 42 to 60 years old who did not report having cardiovascular disease or cancer. Physical activity was assessed quantitatively with a detailed questionnaire, and maximal oxygen uptake was measured directly by exercise testing. During an average follow-up of 4.9 years, 42 of the 1166 men with normal electrocardiograms at base line had a first acute myocardial infarction. RESULTS: After adjustment for age and the year of examination, the relative hazard (risk) of myocardial infarction in the third of subjects with the highest level of physical activity (> 2.2 hours per week) was 0.31 (95 percent confidence interval, 0.12 to 0.85; P = 0.02), as compared with the third with the lowest level (P = 0.04 for linear trend over all three groups). The relative hazard in the third with the highest maximal oxygen uptake (> 2.7 liters per minute) was 0.26 (95 percent confidence interval, 0.10 to 0.68; P = 0.006) (P = 0.006 for linear trend), after adjustment for age, the year and season when the examination was performed, weight, height, and the type of respiratory-gas analyzer used. After up to 17 confounding variables were controlled for, the relative hazards for the third of subjects with the highest level of physical activity (0.34; 95 percent confidence interval, 0.12 to 0.94; P = 0.04) and maximal oxygen uptake (0.35; 95 percent confidence interval, 0.13 to 0.92; P = 0.03), as compared with the values in the lowest third, were significantly (P < 0.05) less than 1.0. CONCLUSIONS: Higher levels of both leisure-time physical activity and cardiorespiratory fitness had a strong, graded, inverse association with the risk of acute myocardial infarction, supporting the idea that lower levels of physical activity and cardiorespiratory fitness are independent risk factors for coronary heart disease.

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Cite This Study

Lakka et al. (1994) conducted a cohort in Acute myocardial infarction (n=1,453). Leisure-time physical activity vs. Lowest third of physical activity was evaluated on First acute myocardial infarction (HR 0.34, 95% CI 0.12-0.94, p=0.04). Highest levels of leisure-time physical activity significantly reduced the risk of acute myocardial infarction compared to the lowest levels (HR 0.34; 95% CI 0.12-0.94; P=0.04).

synapsesocial.com/papers/6a0f2cb09cac01975e426fedhttps://doi.org/10.1056/nejm199406023302201
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