CLINICAL RESEARCH: PHYSICAL CONDITIONING AND VASCULAR FUNCTION
Walking and Sports Participation and Mortality From Coronary Heart Disease and Stroke
Hiroyuki Noda, MD*,
Hiroyasu Iso, MD*, ,*,
Hideaki Toyoshima, MD ,
Chigusa Date, PhD ,
Akio Yamamoto||,
Shogo Kikuchi, MD¶,
Akio Koizumi, MD#,
Takaaki Kondo, MD,
Yoshiyuki Watanabe, MD**,
Yasuhiko Wada, MD,
Yutaka Inaba, MD,
Akiko Tamakoshi, MD and the JACC Study Group
* Department of Public Health Medicine, Doctoral Program in Social and Environmental Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan
Department of Public Health/Health Information Dynamics, Fields of Science, Program of Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
Department of Food Science and Nutrition, Faculty of Human Life and Environment, Nara Women’s University, Nara, Japan
|| Infectious Disease Surveillance Cancer, Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Environmental Science, Hyogo, Japan
¶ Department of Public Health, Aichi Medical University, Aichi, Japan
# Department of Health and Environmental Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
** Department of Social Medicine & Cultural Sciences, Research Institute for Neurological Diseases & Geriatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
Department of Hygiene, Hyogo College of Medicine, Hyogo, Japan
Department of Epidemiology and Environmental Health, School of Medicine, Juntendo University, Tokyo, Japan
Department of Preventive Medicine/Biostatistics and Medical Decision Making, Field of Social Science, Program in Health and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Manuscript received January 6, 2005;
revised manuscript received June 13, 2005,
accepted July 11, 2005.
* Reprint requests and correspondence: Dr. Hiroyasu Iso, Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Shuita-shi, Osaka 565-0871, Japan. (Email: fvgh5640{at}mb.infoweb.ne.jp).
OBJECTIVES: We aimed to examine the impact of exercise on mortality from cardiovascular disease (CVD) in Asian populations.
BACKGROUND: Few data have been available in Asian countries, where job-related physical activity is higher than that in Western countries.
METHODS: Between 1988 and 1990, 31,023 men and 42,242 women in Japan, ages 40 to 79 years with no history of stroke, coronary heart disease (CHD), or cancer, completed a self-administered questionnaire. Systematic mortality surveillance was performed through 1999, and 1,946 cardiovascular deaths were identified. We chose the second lowest categories of walking and sports participation as the reference to reduce a potential effect of ill health.
RESULTS: Men and women who reported having physical activity in the highest category (i.e., walking  1 h/day or doing sports 5 h/week) had a 20% to 60% lower age-adjusted risk of mortality from CVD, compared with those in the second lowest physical activity category (i.e., walking 0.5 h/day, or sports participation for 1 to 2 h/week). Adjustment for known risk factors, exclusion of individuals who died within two years of baseline inquiry, or gender-specific analysis did not substantially alter these associations. The multivariate-adjusted hazard ratios (95% confidence interval) for the highest versus the second lowest categories of walking or sports participation were 0.71 (0.54 to 0.94) and 0.80 (0.48 to 1.31), respectively, for ischemic stroke (IS); 0.84 (0.64 to 1.09) and 0.51 (0.32 to 0.82), respectively, for CHD; and 0.84 (0.75 to 0.95) and 0.73 (0.60 to 0.90), respectively, for CVD.
CONCLUSIONS: Physical activity through walking and sports participation might reduce the risk of mortality from IS and CHD.
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Abbreviations and Acronyms
| | CHD = coronary heart disease | | CI = confidence interval | | CVD = cardiovascular disease | | HR = hazard ratio | | IPH = intraparenchymal hemorrhage | | IS = ischemic stroke | | SAH = subarachnid hemorrhage |
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