The beneficial effect of physical activity on cardiovascular morbidity and mortality and on all cause mortality is widely acknowledged.¹ However, most of the studies mainly or exclusively relied on reported current activity patterns and investigated mortality measures. In particular, consequences of changing physical activity patterns on cardiovascular disease morbidity have rarely been described.²

We therefore thoroughly reanalysed a case–control study of patients with stable coronary heart disease (CHD) to describe lifetime physical activity patterns and to estimate the risk for CHD associated with lifetime physical activity patterns after careful adjustment for other established risk factors.

METHODS

A detailed description of the study design and methods has been reported in a previous paper on the effects of current physical activity levels on CHD risk and the inflammatory response profile.³ Briefly, 312 patients aged 40–68 years with stable, angiographically confirmed CHD were enrolled. The control group consisted of 479 volunteers who were occasional blood donors and were frequency matched with the patient group for age and sex. The participation rate was 78% of eligible patients and 84% of eligible controls. The study was approved by the ethics committee of the University of Ulm.

Each participant was interviewed about physical activity patterns during each of the following age spans: 20–39 years, …