RT Journal Article
SR Electronic
T1 Estimating the effect of long-term physical activity on cardiovascular disease and mortality: evidence from the Framingham Heart Study
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 649
OP 654
DO 10.1136/heartjnl-2012-303461
VO 99
IS 9
A1 Susan M Shortreed
A1 Anna Peeters
A1 Andrew B Forbes
YR 2013
UL http://heart.bmj.com/content/99/9/649.abstract
AB Objective In the majority of studies, the effect of physical activity (PA) on cardiovascular disease (CVD) and mortality is estimated at a single time point. The impact of long-term PA is likely to differ. Our study objective was to estimate the effect of long-term adult-life PA compared with long-term inactivity on the risk of incident CVD, all-cause mortality and CVD-attributable mortality. Design Observational cohort study. Setting Framingham, MA, USA. Patients 4729 Framingham Heart Study participants who were alive and CVD-free in 1956. Exposures PA was measured at three visits over 30 years along with a variety of risk factors for CVD. Cumulative PA was defined as long-term active versus long-term inactive. Main outcome measures Incident CVD, all-cause mortality and CVD-attributable mortality. Results During 40 years of follow-up there were 2594 cases of incident CVD, 1313 CVD-attributable deaths and 3521 deaths. Compared with long-term physical inactivity, the rate ratio of long-term PA was 0.95 (95% CI 0.84 to 1.07) for CVD, 0.81 (0.71 to 0.93) for all-cause mortality and 0.83 (0.72 to 0.97) for CVD-attributable mortality. Assessment of effect modification by sex suggests greater protective effect of long-term PA on CVD incidence (p value for interaction=0.004) in men (0.79 (0.66 to 0.93)) than in women (1.15 (0.97 to 1.37)). Conclusions Cumulative long-term PA has a protective effect on incidence of all-cause and CVD-attributable mortality compared with long-term physical inactivity. In men, but not women, long-term PA also appears to have a protective effect on incidence of CVD.