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.