European Heart Journal Advance Access published online on January 9, 2008
European Heart Journal, doi:10.1093/eurheartj/ehm574
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The combined influence of leisure-time physical activity and weekly alcohol intake on fatal ischaemic heart disease and all-cause mortality
1 Centre for Alcohol Research, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd Floor, 1399 Copenhagen, Denmark
2 Research Unit for Dietary Studies, Institute of Preventive Medicine, Centre for Health and Society, Copenhagen, Denmark
3 The Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark
Received 16 March 2007; revised 7 November 2007; accepted 14 November 2007.
* Corresponding author. Tel: +45 39207777, Fax: +45 39208010, Email: jpe{at}niph.dk
Aims: To determine the combined influence of leisure-time physical activity and weekly alcohol intake on the risk of subsequent fatal ischaemic heart disease (IHD) and all-cause mortality.
Methods and results: Prospective cohort study of 11 914 Danes aged 20 years or older and without pre-existing IHD. During 
20 years of follow-up, 1242 cases of fatal IHD occurred and 5901 died from all causes. Within both genders, being physically active was associated with lower hazard ratios (HR) of both fatal IHD and all-cause mortality than being physically inactive. Further, weekly alcohol intake was inversely associated with fatal IHD and had a U-shaped association with all-cause mortality. Within level of physical activity, non-drinkers had the highest HR of fatal IHD, whereas both non-drinkers and heavy drinkers had the highest HR of all-cause mortality. Further, the physically inactive had the highest HR of both fatal IHD and all-cause mortality within each category of weekly alcohol intake. Thus, the HR of both fatal IHD and all-cause mortality were low among the physically active who had a moderate alcohol intake.
Conclusion: Leisure-time physical activity and a moderate weekly alcohol intake are both important to lower the risk of fatal IHD and all-cause mortality.
Key Words: Physical activity • Alcohol intake • Ischaemic heart disease • All-cause mortality • Survival analysis
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