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Previous Volume 347:716-725 September 5, 2002 Number 10 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Troiano, R. P. Editorial by Thompson, P. D. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The role of walking, as compared with vigorous exercise, in the prevention of cardiovascular disease remains controversial. Data for women who are members of minority racial or ethnic groups are particularly sparse.

Methods We prospectively examined the total physical-activity score, walking, vigorous exercise, and hours spent sitting as predictors of the incidence of coronary events and total cardiovascular events among 73,743 postmenopausal women 50 to 79 years of age in the Women's Health Initiative Observational Study. At base line, participants were free of diagnosed cardiovascular disease and cancer, and all participants completed detailed questionnaires about physical activity. We documented 345 newly diagnosed cases of coronary heart disease and 1551 total cardiovascular events.

Results An increasing physical-activity score had a strong, graded, inverse association with the risk of both coronary events and total cardiovascular events. There were similar findings among white women and black women. Women in increasing quintiles of energy expenditure measured in metabolic equivalents (the MET score) had age-adjusted relative risks of coronary events of 1.00, 0.73, 0.69, 0.68, and 0.47, respectively (P for trend, <0.001). In multivariate analyses, the inverse gradient between the total MET score and the risk of cardiovascular events remained strong (adjusted relative risks for increasing quintiles, 1.00, 0.89, 0.81, 0.78, and 0.72, respectively; P for trend <0.001). Walking and vigorous exercise were associated with similar risk reductions, and the results did not vary substantially according to race, age, or body-mass index. A brisker walking pace and fewer hours spent sitting daily also predicted lower risk.

Conclusions These prospective data indicate that both walking and vigorous exercise are associated with substantial reductions in the incidence of cardiovascular events among postmenopausal women, irrespective of race or ethnic group, age, and body-mass index. Prolonged sitting predicts increased cardiovascular risk.

Source Information

From the Division of Preventive Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston (J.E.M.); the Department of Preventive Medicine, Northwestern University Medical School, Chicago (P.G.); the Fred Hutchinson Cancer Research Center (A.Z.L., M.B.P.) and the Departments of Medicine and Epidemiology (D.S.S.), University of Washington, Seattle; Stanford Center for Research in Disease Prevention, Stanford, Calif. (M.L.S.); the University of Texas Health Science Center, San Antonio (C.P.M.); the Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham (A.O.); and the Department of Clinical and Health Psychology (M.G.P.) and Division of Cardiology (D.S.S.), University of Florida, Gainesville.

Address reprint requests to Dr. Manson at the Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Ave., Boston, MA 02215, or at jmanson{at}rics.bwh.harvard.edu.

Full Text of this Article

Related Letters:

Exercise and the Prevention of Cardiovascular Events in Women
Sobngwi E., Gautier J.-F., Mbanya J.-C., Manson J. E., Greenland P., LaCroix A. Z.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:77-79, Jan 2, 2003. Correspondence

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