Physical activity intervention for males with high risk of coronary heart disease: A three-year follow-up

1977 ◽  
Vol 6 (3) ◽  
pp. 416-425 ◽  
Author(s):  
Juhani Ilmarinen ◽  
Paul S. Fardy
2014 ◽  
Vol 11 (5) ◽  
pp. 966-970 ◽  
Author(s):  
Geeske Peeters ◽  
Richard Hockey ◽  
Wendy Brown

Purpose:This study was designed to compare theoretical strategies for changing physical activity (PA) in terms of their potential to reduce the incidence of chronic conditions in midage women: (1) whole population: +30 minutes/week in all, (2) high-risk: +60 minutes/week in the lowest 25% of the PA distribution, and (3) middle road: shift all those not meeting guidelines to a level commensurate with meeting guidelines.Methods:10,854 participants (50–55 years in 2001) in the Australian Longitudinal Study of Women’s Health completed mail surveys in 2001, 2004, 2007, and 2010. PA was calculated as MET·minutes/week spent in walking, moderate and vigorous PA in the previous week. Incidence rates per 1000 person-years for diabetes, heart disease, hypertension, cancer, and depression were calculated for the actual distribution and after modeled shifts in PA.Results:The incidence rates were 10.6 for diabetes, 7.0 for heart disease, 30.7 for hypertension, 8.0 for cancer, and 28.4 for depression. Greater reductions in incidence were found for the middle road strategy than for the whole population and high-risk strategies, with reductions ranging from –6.3% for cancer to –12.3% for diabetes.Discussion:This theoretical modeling showed that a middle road strategy to increasing PA was superior to the whole population and high-risk strategies, in terms of reducing incidence rates of chronic conditions in middle-aged women.


2005 ◽  
Vol 41 (1) ◽  
pp. 219-225 ◽  
Author(s):  
Kristina Sundquist ◽  
Jan Qvist ◽  
Sven-Erik Johansson ◽  
Jan Sundquist

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Andrea K Chomistek ◽  
Kenneth J Mukamal ◽  
A. H Eliassen ◽  
Eric B Rimm

Background: The majority of studies on the association between physical activity and coronary heart disease (CHD) risk have been conducted in middle-aged and older populations. Although physical activity has been shown to lower risk of CHD in women by approximately 30%, evidence for the benefits of exercise for CHD in young women is very limited. Methods and Results: We conducted a prospective cohort study among 114 054 women, 25–42 years of age at baseline, enrolled in the Nurses’ Health Study II and followed from 1989 to 2009. Leisure-time physical activity was assessed at baseline and during follow-up through a series of questions on the specific type of activity and the average time per week spent on the activity over the previous year. Additionally, at baseline, women were asked the number of months per year they participated in strenuous exercise or sports during high school and ages 18–22. During 20 years of follow-up, we documented 518 new cases of non-fatal MI and fatal CHD. After adjusting for age and other cardiovascular risk factors, the rate ratios (RR) (95% confidence intervals [CI]) corresponding to 0, 0.1 – 3.5, 3.6 – 8.8, 8.9 – 21.0, and > 21 MET-hours/week of physical activity were 1.0, 0.93 (0.71, 1.21), 0.73 (0.56, 0.95), 0.67 (0.52, 0.88), and 0.63 (0.49, 0.83) (p for trend = 0.001). There was no evidence of effect modification by age or body mass index. Specifically in women less than 50 years of age, the corresponding RR were 1.0, 0.97 (0.70, 1.35), 0.75 (0.53, 1.04), 0.69 (0.50, 0.96), and 0.63 (0.45, 0.88) (p for trend = 0.008). Brisk walking alone was also associated with significant reductions in CHD risk. In contrast to physical activity during adulthood, frequency of participation in strenuous activity in high school or during ages 18–22 was not associated with risk of CHD when adjusted for current physical activity. Conclusions: These prospective data suggest that physical activity is associated with substantial risk reductions in the incidence of coronary heart disease in young women.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N Gonzalez ◽  
M Wilhelm ◽  
A Arango ◽  
V Gonzalez ◽  
C Mesa ◽  
...  

Abstract Background Current guidelines recommend that adults with chronic health conditions should engage in regular physical activity (PA), and avoid inactivity. Yet, the exact role of PA trajectories in the mortality risk of patients with coronary heart disease (CHD) remains unclear. Purpose We aimed to perform a systematic review and meta-analysis on the association of longitudinal trajectories of PA with all-cause and cardiovascular disease (CVD) mortality in patients with CHD. Methods We performed a systematic review and meta-analysis based on PRISMA statement. Six electronic databases were searched for cohort studies that analysed the association of PA trajectories (inactive over time, active over time, increased activity over time, and decreased activity over time) with the risk of all-cause and CVD mortality in patients with CHD. Study quality was evaluated by the Newcastle Ottawa scale. We used the inverse variance weighted method to combine summary measures using random-effects models to minimize the effect of between-study heterogeneity. The study is registered in PROSPERO. Results We meta-analyzed nine longitudinal cohorts involving 33,576 patients (25010 acute CHD, 8566 chronic CHD, mean age 62.5 years, 34% women, median follow-up duration 7.2 years), according to four PA trajectories. All studies assessed PA through validated questionnaires. The definitions of activity and inactivity at baseline and follow-ups were in agreement with current PA guidelines. Trajectories were calculated based on comparison of activity status at baseline and follow-up. All the studies defined increased activity over time as moving from the inactive to the active category, and decreased activity over time as moving from the active to the inactive category. Compared to patients remaining inactive over time, the lowest risk of all-cause and CVD mortality was observed in patients remaining active over time (HR [95% CI]: 0.50 [0.39–0.63] and 0.48 [0.35–0.68], respectively), followed by patients who increased their PA over time (HR [95% CI]:0.55 [0.44–0.7] and 0.63 [0.51–0.78], respectively), and patients who decreased activity over time (HR [95% CI]: 0.80 [0.64–0.99] and 0.91 [0.67–1.24], respectively). These results were consistent both in the acute and chronic CHD settings. The overall risk of bias was low, and no evidence of publication bias was observed. Multiple sensitivity analyses provided consistent results. Conclusions In patients with CHD, the risk of all-cause and CVD mortality is progressively reduced from being inactive over time, to decreased activity over time, to increased activity over time, to being active over time. These findings highlight the benefits of adopting a more physically active lifestyle in patients with chronic and acute CHD, independent of previous PA levels. Future studies should clarify the complex interactions between motivations and disease severity as potential drivers for PA trajectories FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): University of Bern


2021 ◽  
pp. jech-2020-214358
Author(s):  
Pekka Martikainen ◽  
Kaarina Korhonen ◽  
Aline Jelenkovic ◽  
Hannu Lahtinen ◽  
Aki Havulinna ◽  
...  

BackgroundGenetic vulnerability to coronary heart disease (CHD) is well established, but little is known whether these effects are mediated or modified by equally well-established social determinants of CHD. We estimate the joint associations of the polygenetic risk score (PRS) for CHD and education on CHD events.MethodsThe data are from the 1992, 1997, 2002, 2007 and 2012 surveys of the population-based FINRISK Study including measures of social, behavioural and metabolic factors and genome-wide genotypes (N=26 203). Follow-up of fatal and non-fatal incident CHD events (N=2063) was based on nationwide registers.ResultsAllowing for age, sex, study year, region of residence, study batch and principal components, those in the highest quartile of PRS for CHD had strongly increased risk of CHD events compared with the lowest quartile (HR=2.26; 95% CI: 1.97 to 2.59); associations were also observed for low education (HR=1.58; 95% CI: 1.32 to 1.89). These effects were largely independent of each other. Adjustment for baseline smoking, alcohol use, body mass index, igh-density lipoprotein (HDL) and total cholesterol, blood pressure and diabetes attenuated the PRS associations by 10% and the education associations by 50%. We do not find strong evidence of interactions between PRS and education.ConclusionsPRS and education predict CHD events, and these associations are independent of each other. Both can improve CHD prediction beyond behavioural risks. The results imply that observational studies that do not have information on genetic risk factors for CHD do not provide confounded estimates for the association between education and CHD.


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