Estimating the effect of long-term physical activity on cardiovascular disease and mortality: evidence from the Framingham Heart Study

Heart. 2013 May;99(9):649-54. doi: 10.1136/heartjnl-2012-303461. Epub 2013 Mar 8.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / prevention & control
  • Cohort Studies
  • Exercise*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Mortality
  • Sedentary Behavior*
  • Sex Factors
  • United States / epidemiology