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Heartbeat: cardiovascular risk is reduced by leisure-time, but not occupational, physical activity
  1. Catherine M Otto
  1. Division of Cardiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Professor Catherine M Otto, Division of Cardiology, University of Washington, Seattle, WA 98195, USA; cmotto{at}

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Cardiovascular disease (CVD) risk is lower in healthy people who engage in regular leisure time physical activity (LTPA). Paradoxically, occupational physical activity (OPA) appears to be associated with a higher CVD risk. To better understand the relationship between physical activity, diabetes and risk of adverse outcomes in patients with known CVD, Bonekamp and colleagues1 quantified these associations in 7058 CVD patients (mean age 61±10 years, 75% male) prospectively followed for an average 8.6 years. Overall mortality was 18% with a lower risk in the top quartile of LTPA, compared with the lowest quartile (HR 0.63, 95% CI 0.54 to 0.74). The risk of recurrent CVD events and diabetes also was lower in the highest quartile of LTPA (figure 1). Conversely, heavy manual OPA, compared with sedentary work, showed a trend towards an increased risk of all-cause mortality (HR 1.08, 95% CI 0.86 to 1.35) as well as CVD events and diabetes.

Figure 1

Continuous association between leisure-time physical activity and risk of all-cause mortality, recurrent cardiovascular events and incident type 2 diabetes. associations between continuous leisure-time physical activity and all-cause mortality (A), recurrent vascular events (B) and incident type 2 diabetes (C). HRs are adjusted for age, sex, smoking status, pack years, alcohol consumption, education and current employment (model 3). The histograms inside the figures represent the number of study participants that achieved a certain leisure-time physical activity level. METh/wk, metabolic equivalent of task hours per week.

Cuthberson and colleagues2 summarise how these findings fit in the context of previous studies on types of physical activity and CVD risk. As they point out, the apparent paradox that leisure-time, but not occupational, physical activity is associated …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.