Walking and Primary Prevention: A Meta-analysis of Prospective Cohort Studies

Mark Hamer ^1* and Yoichi Chida ¹

¹ University College London, United Kingdom

^* To whom correspondence should be addressed. E-mail: m.hamer{at}ucl.ac.uk.

Accepted 20 November 2007

Abstract

Objective: To quantify the association between walking and risk of cardiovascular disease (CVD) and all cause mortality in healthy men and women. Data sources: We searched Medline, Cochrane Database of Systematic Reviews, and Web of Science databases through May 2007. Study selection Prospective epidemiological studies of walking and CVD and all cause mortality. Results: We included eighteen prospective studies in the overall analysis, which incorporated 459,833 participants free from CVD at baseline with 19,249 cases at follow up. From the meta-analysis the pooled hazard ratio of CVD in the highest walking category compared with the lowest was 0.69, (95% confidence interval 0.61 to 0.77, P < 0.001), and 0.68 (0.59 to 0.78, P < 0.001) for all cause mortality. These effects were robust among men and women, although there was evidence of publication biases for the associations with CVD risk. Walking pace was a stronger independent predictor of overall risk compared with walking volume (48% vs. 26% risk reductions respectively). There was also evidence of a dose response relationship across the highest, intermediate, and lowest walking categories in relation to the outcome measures. Conclusions: Our results suggest walking is inversely associated with clinical disease endpoints and largely support the current guidelines for physical activity. The mechanisms that mediate this relationship remain largely unknown and should be the focus of future research.

Key Words: cardiovascular risk, epidemiology, meta analysis, physical activity, walking

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Wikinomics, Steven Blair and the Zurich International Conference on Concussion in Sport

Karim Khan
Br. J. Sports Med. 2008 42: 235. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Gordon-Larsen, P., Boone-Heinonen, J., Sidney, S., Sternfeld, B., Jacobs, D. R. Jr, Lewis, C. E. (2009). Active Commuting and Cardiovascular Disease Risk: The CARDIA Study. Arch Intern Med 169: 1216-1223 [Abstract] [Full Text]  
• Stamatakis, E., Hamer, M., Lawlor, D. A. (2009). Physical Activity, Mortality, and Cardiovascular Disease: Is Domestic Physical Activity Beneficial?: The Scottish Health Survey--1995, 1998, and 2003. Am J Epidemiol 169: 1191-1200 [Abstract] [Full Text]  
• Winett, R A, Williams, D M, Davy, B M (2009). Initiating and maintaining resistance training in older adults: a social cognitive theory-based approach. Br. J. Sports. Med. 43: 114-119 [Abstract] [Full Text]  
• Khan, K. M (2008). Debating transversus abdominis, the "exercise pill" and whether flying limits athletes' performance on arrival. Br. J. Sports. Med. 42: 861-861 [Full Text]  
• Stovitz, S. (2008). Sports medicine, on the forefront of spreading a little love in this world. Br. J. Sports. Med. 42: 313-313 [Full Text]