Background Previous studies have suggested that higher levelsof regular physical activity and cardiorespiratory fitness areassociated with a reduced risk of coronary heart disease. Weinvestigated the independent associations of physical activityduring leisure time and maximal oxygen uptake (a measure ofcardiorespiratory fitness) with the risk of acute myocardialinfarction.
Methods During the period 1984 to 1989, we performed base-lineexaminations in 1453 men 42 to 60 years old who did not reporthaving cardiovascular disease or cancer. Physical activity wasassessed quantitatively with a detailed questionnaire, and maximaloxygen uptake was measured directly by exercise testing. Duringan average follow-up of 4.9 years, 42 of the 1166 men with normalelectrocardiograms at base line had a first acute myocardialinfarction.
Results After adjustment for age and the year of examination,the relative hazard (risk) of myocardial infarction in the thirdof subjects with the highest level of physical activity (>2.2hours per week) was 0.31 (95 percent confidence interval, 0.12to 0.85; P = 0.02), as compared with the third with the lowestlevel (P = 0.04 for linear trend over all three groups). Therelative hazard in the third with the highest maximal oxygenuptake (>2.7 liters per minute) was 0.26 (95 percent confidenceinterval, 0.10 to 0.68; P = 0.006) (P = 0.006 for linear trend),after adjustment for age, the year and season when the examinationwas performed, weight, height, and the type of respiratory-gasanalyzer used. After up to 17 confounding variables were controlledfor, the relative hazards for the third of subjects with thehighest level of physical activity (0.34; 95 percent confidenceinterval, 0.12 to 0.94; P = 0.04) and maximal oxygen uptake(0.35; 95 percent confidence interval, 0.13 to 0.92; P = 0.03),as compared with the values in the lowest third, were significantly(P<0.05) less than 1.0.
Conclusions Higher levels of both leisure-time physical activityand cardiorespiratory fitness had a strong, graded, inverseassociation with the risk of acute myocardial infarction, supportingthe idea that lower levels of physical activity and cardiorespiratoryfitness are independent risk factors for coronary heart diseasein men.
Source Information
From the Research Institute of Public Health, University of Kuopio (T.A.L., R.S., J.T.S.), and the Kuopio Research Institute of Exercise Medicine (J.M.V., R.R., R.S.), Kuopio, Finland; and the Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland (J.T.).
Address reprint requests to Professor J.T. Salonen at the University of Kuopio, P.O. Box 1627, 70211 Kuopio, Finland.
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