Reductions in incident coronary heart disease risk above guideline physical activity levels in men

Abstract

Background: One-half of Americans currently meet guideline physical activity levels. For these individuals, exceeding guideline levels may provide additional health benefits.

Methods: Incident physician-diagnosed myocardial infarction and angina, revascularization procedures (CABG, PTCA), and ischemic heart disease deaths during 7.7-year follow-up were compared to baseline usual distance run in 35,402 male runners.

Results: Men reported 467 incident CHD and the National Death Index identified an additional 54 ischemic heart disease deaths. Per km/day run, the men's risks declined 5% for fatal and nonfatal CHD (P=0.001), nonfatal CHD (P=0.0008), and revascularization procedures (P=0.002). Their risks for nonfatal myocardial infarctions and angina declined 7% (P=0.02) and 10% (P=0.003), respectively. Compared to <3km/day run (upper limit guideline level), >9km/day run produced risks 65% lower for angina (P=0.008), 29% lower for nonfatal CHD (P=0.04), and 26% lower for fatal and nonfatal CHD (P=0.06).

Conclusions: Exceeding guideline physical activity levels produce important CHD-risk reductions.

Figure 1

Relative risk from survival analyses of participant-reported physician-diagnosed angina and nonfatal CHD (i.e., myocardial infarction, revascularization procedures and angina) by physical activity (km/day running distance) in 28,287 men. Risks adjusted for age, education, intakes of meat, fish, fruit and alcohol, aspirin use, and pack-years of past cigarette use. Significance levels provided above the bars and to the left of the arrows are relative to all higher running distances (e.g., men who exceed 6 km/day have significantly lower risk for nonfatal CHD than men who average 3–6 km/day at P = 0.006). Significant differences relative to the lowest-mileage runners are coded *P < 0.05 and †P < 0.01.