Association of sports activities in leisure time and incident myocardial infarction in middle-aged men and women from the general population: the MONICA/KORA Augsburg cohort study
Restricted accessResearch articleFirst published online December, 2007
Association of sports activities in leisure time and incident myocardial infarction in middle-aged men and women from the general population: the MONICA/KORA Augsburg cohort study
To examine sex-specific associations between sports activities in leisure time and incident myocardial infarction (MI) in a representative population sample in Germany.
Design
Cohort study.
Methods
The study was based on 3501 men and 3475 women (aged 45-74 years) who participated in one of the three MONICA Augsburg surveys between 1984 and 1995 and were followed up until 2002. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazard models.
Results
A total of 295 cases of incident MIs among men and 91 among women were registered during a median follow-up period of 8.6 years. In both sexes, moderate and high level of sports activities in leisure time were associated with a reduced risk of incident MI after age and survey adjustment; the HRs of MIs associated with a moderate and high level of sports activities in leisure time were 0.68 (0.49-0.96), and 0.71 (0.50-0.99) for men and 0.42 (0.21-0.84), and 0.18 (0.04-0.74) for women. Further adjustment for other major coronary heart disease risk factors attenuated the HRs: in moderately and highly active men, the HRs were not significant anymore (HRs 0.78 and 0.84, respectively), but the HRs remained significantly reduced in moderately and highly active women (HR 0.49; 95% CI, 0.24-1.00 and HR 0.21; 95% CI, 0.05-0.87, respectively).
SessoHDPaffenbargerRSLeeIM.Physical activity and coronary heart disease in men. The Harvard Alumni Health Study. Circulation2000; 102: 975–980.
2.
WilliamsPT.Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc2001; 33: 754–761.
3.
TanasescuMLeitzmanMFRimmEBWillettWCStampferMJHuFB.Exercise type and intensity in relation to coronary heart disease in men. JAMA2002; 288: 1994–2000.
4.
WagnerASimonCEvansAFerrieresJMontayeMDucimetiereP, et al. Physical activity and coronary event incidence in Northern Ireland and France. The Prospective Epidemiological Study of Myocardial Infarction (PRIME). Circulation2002; 105: 2247–2252.
5.
YuSYarnellJWSweetnamPMMurrayL.What level of physical activity protects against premature cardiovascular death? The Caerphilly study. Heart2003; 89: 502–506.
6.
MansonJEHuFBRich-EdwardsJWColditzGAStampferMJWillettWC, et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. N Engl J Med1999; 341: 650–658.
7.
LeeIMRexrodeKMCookNRMansonJEBuringJE.Physical activity and coronary heart disease in women. Is‘no pain, no gain’ passé? JAMA2001; 285: 1447–1454.
8.
FolsomARArnettDKHutchinsonRGLiaoFCleggLXCooperLS.Physical activity and incidence of coronary heart disease in middle-aged women and men. Med Sci Sports Exerc1997; 29: 901–909.
9.
HuGJousilahtiPBorodulinKBarengoNCLakkaTANissinenA, et al. Occupational, commuting and leisure-time physical activity in relation to coronary heart disease among middle-aged Finnish men and women. Atherosclerosis 2006. Doi:10.1016/j.atherosclerosis.2006.08.051 [Epub ahead of print].
10.
HaapanenNMiilunpaloSVuoriIOjaPPasanenM.Association of leisure time physical activity with the risk of coronary heart disease, hypertension and diabetes in middle-aged men and women. Int J Epidemiol1997; 26: 739–747.
11.
KeilULieseADHenseHWFilipiakBDöringAStieberJ, et al. Classical risk factors and their impact on incident non-fatal and fatal myocardial infarction and all-cause mortality in southern Germany. Results from the MONICA Augsburg cohort study 1984-1992. Eur Heart J1998; 19: 1197–1207.
12.
MeisingerCThorandBSchneiderAStieberJDöringALöwelH.Sex differences in risk factors for incident type 2 diabetes mellitus: the MONICA Augsburg cohort study. Arch Intern Med2002; 162: 82–89.
13.
LoewelHLewisMHoermannAKeilU.Case finding, data quality aspects and comparability of myocardial infarction registers: results of a south German register study. J Clin Epidemiol1991; 44: 249–260.
14.
The Joint European Society of Cardiology/American College of Cardiology Committee.Myocardial infarction redefined - a consensus document of The Joint European Society of Cardiology/American College of Cardiology for the redefinition of myocardial infarction. J Am Coll Cardiol2000; 36: 959–969.
15.
WilliamsPT.High-density lipoprotein cholesterol and other risk factors for coronary heart disease in female runners. N Engl J Med1996; 334: 1298–1303.
16.
Mayer-DavisEJD'AgostinoRJrKarterAJHaffnerSMRewersMJSaadM, et al. Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. JAMA1998; 279: 669–674.
17.
HambrechtRWolfAGielenSLinkeAHoferJErbsS, et al. Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med2000; 342: 454–460.
18.
WannametheeSGLoweGDWhincupPHRumleyAWalkerMLennonL.Physical activity and hemostatic and inflammatory variables in elderly men. Circulation2002; 105: 1785–1790.
19.
NIH Consensus Development Panel on Physical Activity and Cardiovascular Health Physical activity and cardiovascular health. JAMA1996; 276: 241–246.
