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Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Exercise Type and Intensity in Relation to Coronary Heart Disease in Men. JAMA. 2002;288(16):1994–2000. doi:10.1001/jama.288.16.1994
Author Affiliations: Departments of Nutrition (Drs Tanasescu, Leitzmann, Rimm, Willett, Stampfer, and Hu) and Epidemiology (Drs Leitzmann, Rimm, Willett, and Stampfer), Harvard School of Public Health; the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School (Drs Rimm, Willett, Stampfer, and Hu).
Context Studies have shown an inverse relationship between exercise and risk
of coronary heart disease (CHD), but data on type and intensity are sparse.
Objective To assess the amount, type, and intensity of physical activity in relation
to risk of CHD among men.
Design, Setting, and Participants A cohort of 44 452 US men enrolled in the Health Professionals'
Follow-up Study, followed up at 2-year intervals from 1986 through January
31, 1998, to assess potential CHD risk factors, identify newly diagnosed cases
of CHD, and assess levels of leisure-time physical activity.
Main Outcome Measure Incident nonfatal myocardial infarction or fatal CHD occurring during
the follow-up period.
Results During 475 755 person-years, we documented 1700 new cases of CHD.
Total physical activity, running, weight training, and rowing were each inversely
associated with risk of CHD. The RRs (95% confidence intervals [CIs]) corresponding
to quintiles of metabolic equivalent tasks (METs) for total physical activity
adjusted for age, smoking, and other cardiovascular risk factors were 1.0,
0.90 (0.78-1.04), 0.87 (0.75-1.00), 0.83 (0.71-0.96), and 0.70 (0.59-0.82)
(P<.001 for trend). Men who ran for an hour or
more per week had a 42% risk reduction (RR, 0.58; 95% CI, 0.44-0.77) compared
with men who did not run (P<.001 for trend). Men
who trained with weights for 30 minutes or more per week had a 23% risk reduction
(RR, 0.77; 95% CI, 0.61-0.98) compared with men who did not train with weights
(P = .03 for trend). Rowing for 1 hour or more per
week was associated with an 18% risk reduction (RR, 0.82; 05% CI, 0.68-0.99).
Average exercise intensity was associated with reduced CHD risk independent
of the total volume of physical activity. The RRs (95% CIs) corresponding
to moderate (4-6 METs) and high (6-12 METs) activity intensities were 0.94
(0.83-1.04) and 0.83 (0.72-0.97) compared with low activity intensity (<4
METs) (P = .02 for trend). A half-hour per day or
more of brisk walking was associated with an 18% risk reduction (RR, 0.82;
95% CI, 0.67-1.00). Walking pace was associated with reduced CHD risk independent
of the number of walking hours.
Conclusions Total physical activity, running, weight training, and walking were
each associated with reduced CHD risk. Average exercise intensity was associated
with reduced risk independent of the number of MET-hours spent in physical
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