PT  - JOURNAL ARTICLE
AU  - H Noda
AU  - H Iso
AU  - H Toyoshima
AU  - C Date
AU  - A Yamamoto
AU  - S Kikuchi
AU  - A Koizumi
AU  - T Kondo
AU  - Y Watanabe
AU  - Y Wada
AU  - Y Inaba
AU  - A Tamakoshi
TI  - Smoking status, sports participation and mortality from coronary heart disease
AID  - 10.1136/hrt.2007.126458
DP  - 2008 Apr 01
TA  - Heart
PG  - 471--475
VI  - 94
IP  - 4
4099  - http://heart.bmj.com/content/94/4/471.short
4100  - http://heart.bmj.com/content/94/4/471.full
SO  - Heart2008 Apr 01; 94
AB  - Background: Since smoking and exercise have opposite effects on coronary risk factors, the hypothesis was proposed that smoking might weaken the protective effect of exercise on prevention of coronary heart disease.Objective: To determine the effect of smoking on the relationship between sports participation and mortality from coronary heart disease.Design: Population-based prospective cohort study in Japan.Participants: A total of 76 832 Japanese men and women, aged 40–79 years with no history of stroke, coronary heart disease, or cancer, completed a self-administered questionnaire between 1988 and 1990.Main outcome measures: Systematic mortality surveillance was carried out through 2003, and 638 deaths from coronary heart disease (496 myocardial infarction) were identified.Results: People who reported the longest time in sports participation (⩾5 hours/week) had an approximately 50–80% lower age-adjusted risk of mortality from coronary heart disease compared with those in the second lowest category (1–2 hours/week) among never and ex-smokers, but no association was found among current smokers. Adjustment for known risk factors and exclusion of subjects who died within 2 years of the baseline inquiry did not substantially alter these associations. The multivariable hazard ratios (95% confidence interval) of coronary heart disease for the ⩾5 hours/week versus 1–2 hours/week of sports participation were 0.44 (0.23 to 0.86) among never smokers, 0.18 (0.05 to 0.60) among ex-smokers, and 0.82 (0.47 to 1.40) among current smokers. Similar associations were found for men and women.Conclusions: Smoking may reduce the beneficial effect of sports participation for reduction of fatal coronary heart disease.