Is it Hypertension or Physical Inactivity: Cardiovascular Risk and Mortality – New results in 3/2013
Reporter: Aviva Lev-Ari, PhD, RN
UPDATED on 5/13/2014
- Original article
Comparing population attributable risks for heart disease across the adult lifespan in women
+Author Affiliations
- Correspondence toProfessor Wendy J Brown, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement Studies, University of Queensland, Blair Drive, St Lucia, QLD 4072, Australia; wbrown@hms.uq.edu.au
- Accepted 11 February 2014
- Published Online First 8 May 2014
Abstract
Background Recent estimates suggest that high body mass index (BMI), smoking, high blood pressure (BP) and physical inactivity are leading risk factors for the overall burden of disease in Australia. The aim was to examine the population attributable risk (PAR) of heart disease for each of these risk factors, across the adult lifespan in Australian women.
Methods PARs were estimated using relative risks (RRs) for each of the four risk factors, as used in the Global Burden of Disease Study, and prevalence estimates from the Australian Longitudinal Study on Women’s Health, in 15 age groups from 22–27 (N=9608) to 85–90 (N=3901).
Results RRs and prevalence estimates varied across the lifespan. RRs ranged from 6.15 for smoking in the younger women to 1.20 for high BMI and high BP in the older women. Prevalence of risk exposure ranged from 2% for high BP in the younger women to 79% for high BMI in mid-age women. In young adult women up to age 30, the highest population risk was attributed to smoking. From age 31 to 90, PARs were highest for physical inactivity.
Conclusions From about age 30, the population risk of heart disease attributable to inactivity outweighs that of other risk factors, including high BMI. Programmes for the promotion and maintenance of physical activity deserve to be a much higher public health priority for women than they are now, across the adult lifespan.
SOURCE
http://bjsm.bmj.com/content/early/2014/04/15/bjsports-2013-093090.abstract
Heart doi:10.1136/heartjnl-2012-303461
- Epidemiology
- Original article
Estimating the effect of long-term physical activity on cardiovascular disease and mortality: evidence from the Framingham Heart Study
+Author Affiliations
1Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
2Biostatistics Unit, Group Health Research Institute, Seattle, Washington, USA
3Obesity and Population Health Unit, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
Correspondence toDr Susan M Shortreed, Biostatistics Unit, Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA; shortreed.s@ghc.org
- Published Online First 8 March 2013
Abstract
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.
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