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European Heart Journal Advance Access originally published online on February 1, 2008
European Heart Journal 2008 29(5):602-608; doi:10.1093/eurheartj/ehn012
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Is vigorous physical activity contraindicated in subjects with coronary heart disease? Evidence from the Caerphilly study

Shicheng Yu1, Christopher C. Patterson2 and John W.G. Yarnell2,*

1 OHSAH in British Columbia, Ministry of Health Services, Vancouver, Canada
2 Department of Epidemiology and Public Health, Queen's University Belfast, Mulhouse Building, Royal Victoria Hospital Site, Grosvenor Road, Belfast BT12 6BJ, UK

Received 4 September 2007; revised 6 December 2007; accepted 7 January 2008; online publish-ahead-of-print 1 February 2008.

* Corresponding author. Tel: +44 28 9063 2746, Fax: +44 28 9023 1907, Email: h.porter{at}qub.ac.uk or j.yarnell{at}qub.ac.uk

Aims: A large study of British civil servants reported that, in men with electrocardiogram ischaemia but no symptoms, vigorous habitual leisure activity might be associated with increased subsequent risk of myocardial infarction (MI). We examine this for MI and stroke in a general population of British men.

Methods and results: Between 1984 and 1988, 2398 middle-aged men were recruited into the cohort in Caerphilly, South Wales, UK. Physical activities during leisure and at work were assessed by validated questionnaires. Follow-up was for 12 years, and both fatal and non-fatal cardiovascular events (MI, stroke or MI, and stroke) were recorded. After adjustment for age and other confounders, men in the highest third of vigorous physical activity experienced decreased risk of MI, relative to men in the lowest third; hazard ratios (HR) (95% CI) were 0.71 (0.50, 1.03), 0.42 (0.19, 0.92), and 0.60 (0.38, 0.94) in men with symptomatic, asymptomatic coronary heart disease (CHD), and no evidence of CHD at baseline, respectively. HRs for stroke were non-significantly raised for subjects with asymptomatic CHD (1.36 (0.47, 3.91).

Conclusion: Habitual vigorous activity was not associated with increased risk of subsequent MI in subjects with established CHD, but additional data for stroke would be useful.

Key Words: Vigorous exercise • Risk • Coronary heart disease • Stroke • Asymptomatic coronary disease • Longitudinal study


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