Physical activity and mortality in older men with diagnosed coronary heart disease

Abstract

Background: We have studied the relations between physical activity, types of physical activity, and changes in physical activity and all-cause mortality in men with established coronary heart disease (CHD).

Methods and results: In 1992, 12 to 14 years after the initial screening (Q1) of 7735 men 40 to 59 years of age from general practices in 24 British towns, 5934 (91% of available survivors, mean age 63 years) provided further information on physical activity (Q92) and were followed up for 5 years; 963 had a physician's diagnosis of CHD (myocardial infarction or angina). After exclusions, there were 772 men with established CHD, 131 of whom died of all causes. The lowest risks for all-cause and cardiovascular mortality were seen in light and moderate activity groups (adjusted relative risk compared with inactive/occasionally active: light, 0.42 (0.25, 0.71); moderate, 0.47 (0.24, 0.92); and moderately vigorous/vigorous, 0.63 (0.39, 1.03). Recreational activity of >/=4 hours per weekend, moderate or heavy gardening, and regular walking (>40 min/d) were all associated with a significant reduction in all-cause mortality. Nonsporting activity was more beneficial than sporting activities. Men sedentary at Q1 who began at least light activity by Q92 showed lower mortality rates on follow-up than those who remained sedentary (relative risk 0.58, 95% CI 0.33 to 1.03; P:=0.06).

Conclusions: Light or moderate activity in men with established CHD is associated with a significantly lower risk of all-cause mortality. Regular walking and moderate or heavy gardening were sufficient to achieve this benefit.