ArticlesChanges in physical activity, mortality, and incidence of coronary heart disease in older men
Introduction
For middle-aged men, regular leisure-time physical activity is associated with lower all-cause mortality and with lower morbidity and mortality from cardiovascular disease.1, 2, 3, 4, 5, 6, 7 There is also evidence that older people benefit from physical activity.8, 9 However, despite the benefits of physical activity, many middle-aged adults in the UK and the USA do little or no regular physical activity in their leisure time.10, 11 There has been little investigation of whether adoption of regular physical activity in later adult life is beneficial. Two US studies have suggested that adoption of physical activity or improved fitness even in later life improves mortality outcome.12, 13 However, in a study of Danish men,14 increased physical activity by men aged over 64 was associated with increased risk of coronary heart disease, and in a study of Swedish women aged 38–60 increased physical activity was associated with a slight excess mortality.15
We used data from the British Regional Heart Study to find out whether middle-aged or elderly men should be advised to begin or to increase physical activity in later life. We studied the association between physical activity in older men, all-cause mortality, and the incidence of coronary heart disease. We also assessed the relation between changes in physical activity in these men during the preceding 12–14 years and subsequent mortality outcome.
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Data collection
The British Regional Heart Study is a large prospective study of cardiovascular disease, which began in 1978. At this time, 7735 men aged 40–59 were selected from the age-sex registers of one group general practice in each of 24 towns in England, Wales, and Scotland. The criteria for selection of the town, the general practice, and the participants, and the data collection methods, are described elsewhere.16 In 1978–80 (Q1) research nurses completed for each man a standard questionnaire that
Background data
The mean age of the 5567 men who completed the physical-activity questionnaire at Q92 was 63 years (range 52–72 years). 1256 men (22·6%) had a history of coronary heart disease, stroke, or other heart trouble, or reported “poor health”. In this group 198 men died (121 from cardiovascular, 77 from other causes) during the 4-year follow-up period-a mortality rate of 40·0 per 1000 person-years. Since coronary heart disease, stroke, other heart trouble, and self-reported “poor health” may influence
Discussion
The benefits of regular leisure-time physical activity on health are widely recognised. Reports from the British Regional Heart Study have studied the links between physical activity at baseline and health outcome, and have confirmed the benefits to health of regular physical activity for middle-aged men.6, 7, 22 We have shown that sporting (vigorous) activity is not essential for reduction of cardiovascular risk, that regular physical activity for men over 60 brings a significant decrease in
References (30)
- et al.
Does exercise reduce mortality rates in the elderly? Experience from the Framingham Heart study
Am Heart J
(1994) - et al.
Assessment methods for physical activity and physical fitness in population studies: report of a NHLBI workshop
Am Heart J
(1986) - et al.
A questionnaire for the assessment of leisure time physical activities
J Chronic Dis
(1978) - et al.
Vigorous exercise in leisure time and the death rate: a study of male civil servants
J Epidemiol Community Health
(1978) - et al.
Physical activity, all cause mortality and longevity of college alumni
N Engl J Med
(1986) - et al.
Leisure-time physical activity levels and risk of coronary heart disease and death: the Multiple Risk Factor Intervention trial
JAMA
(1987) - et al.
Leisure time physical activity and coronary heart disease death: the US Railroad Study
Circulation
(1989) - et al.
Exercise in leisure time: coronary attack and death rates
Br Heart J
(1990) - et al.
Physical activity and ischaemic heart disease in middle-aged men
Br Heart J
(1991) - et al.
Physical activity and risk of stroke in British middle-aged men
BMJ
(1992)