Elsevier

Atherosclerosis

Volume 194, Issue 2, October 2007, Pages 490-497
Atherosclerosis

Occupational, commuting and leisure-time physical activity in relation to coronary heart disease among middle-aged Finnish men and women

https://doi.org/10.1016/j.atherosclerosis.2006.08.051Get rights and content

Abstract

Objective

To examine the association of different levels of occupational, commuting, and leisure-time physical activity with the risk of coronary heart disease (CHD) events.

Methods and results

The study comprised 47,840 Finnish participants aged 25–64 years without history of CHD and stroke at baseline. During a mean follow-up of 18.9 years, 4660 new CHD events were documented. The multivariable-adjusted (age, body mass index, systolic blood pressure, total cholesterol, education, alcohol consumption, smoking, history of diabetes, and other two types of physical activity) hazard ratios (HRs) of CHD events associated with low, moderate, and high occupational activity were 1.00, 0.87, and 0.90 (Ptrend = 0.019) for men, and 1.00, 0.75, and 0.80 (Ptrend < 0.001) for women, respectively. The multivariable-adjusted HRs of CHD events associated with low, moderate, and high leisure-time physical activity were 1.00, 0.95, and 0.84 (Ptrend = 0.026) for men, and 1.00, 0.85, and 0.77 (Ptrend = 0.003) for women, respectively. Active commuting had a significant inverse association with the risk of CHD events in women but not in men.

Conclusion

Moderate or high levels of occupational or leisure-time physical activity are associated with a reduced risk of CHD. Daily walking or cycling to and from work is associated with a decreased risk of CHD among women.

Introduction

There is strong evidence that regular physical activity reduces the risk of coronary heart disease (CHD) [1], [2], [3], [4], [5], [6], [7], but the data for women are sparse [1], [3], [6]. Most previous studies have focused on leisure-time physical activity alone [1], [2], [3], [4], [5], [6], [7], whereas the evidence on the association of occupational physical activity with the risk of CHD started to accumulate only in the 1990s [8], [9], [10], [11]. Moreover, only one study has assessed the association of daily walking or bicycling to and from work with the risk of CHD [12]. It is important to understand the separate effects of different forms of physical activity on the risk of CHD because some individuals can increase their physical activity in leisure time, and others may gain health benefits from being more physically active on their way to and from work or at work. In many previous studies physical activity is considered as physical training or other aerobic type of activity. The aim of the present study is to examine whether occupational, commuting, or leisure-time physical activity are independently associated with a reduced CHD risk, and furthermore, how different combinations of physical activity affects the risk.

Section snippets

Subjects

Six independent population surveys were carried out in five geographic areas of Finland in 1972, 1977, 1982, 1987, 1992, and 1997 [13]. In 1972 and 1977, a randomly selected sample 6.6% of the population born between 1913 and 1947 was drawn. Since 1982, the sample was stratified by area, gender and 10-year age group according to the World Health Organization (WHO) MONItoring trends and determinants of CArdiovascular disease (MONICA) protocol [14]. Subjects who participated in more than one

Results

During a mean follow-up of 18.9 years, we identified 4660 new CHD cases (3073 men and 1587 women). General characteristics of the study population at baseline are presented in Table 1.

Age- and study year-adjusted hazard ratios (HRs) of CHD associated with low, moderate, and high occupational physical activity were 1.00, 0.77, and 0.89 (P < 0.001 for trend) for men, and 1.00, 0.65, and 0.78 (P < 0.001 for trend) for women, respectively (Table 2). In multivariable analyses, after further adjustment

Discussion

Moderate or high levels of physical activity at work or during leisure time were associated with a reduced risk of CHD in both sexes. Daily walking or cycling to and from work was associated with a decreased risk of CHD among women. A simultaneous engagement in two or three types of physical activity showed a slightly stronger protective effect than participation in only one type of physical activity.

Only a few studies have assessed the association between occupational physical activity and the

Acknowledgements

This study was supported by grants from the Finnish Academy (grants 46558, 204274, 205657), the Ministry of Education, and the Finnish Foundation for Cardiovascular Research. Dr. Lakka was an Academy Research Fellow of the Academy of Finland.

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