Blackwell Publishing Journal Backfiles 1879-2005
The aim of this study was to analyse prospectively the impact of changes in physical activity level on the risk of ischaemic heart disease (IHD). In 1970–1971, 5249 men aged 40–59 years (mean=48) reported their level of physical activity in leisure time. In 1985–1986, a new baseline was established comprising 75% of survivors who reported their level of physical activity at the time. Some 2894 men aged 53–75, mean=63, free from arteriosclerotic stigmas were included, and their morbidity and mortality were recorded over the next 6 years. Some 181 men had an IHD event; 44 were fatal. A total of 270 men died from all-cause mortality (ACM). Men physically active less than 4 h per week in 1970–1971 had an increased risk of IHD, RR (95% confidence interval)=1.7 (1.1-2.6) compared with men physically more active. For men who reported a sedentary lifestyle, the 1985–1986 RR of IHD was 1.1 (0.9-1.5) compared with more active men. Potential confounders did not explain the results. Among the younger half, those who changed from sedentary to active had a decreased risk of IHD compared with those who remained sedentary (RR=0.6 (0.1-2.5)). In older men, those who changed from sedentary to active had an increased risk of IHD compared with those who remained sedentary (RR=1.9 (0.9-4.2)). In the 6-year follow-up period, the lowest risk of IHD and ACM was found in men who were physically active when reaching midlife and continued to be active. In the younger age group, 40–49 years, taking up a more active lifestyle during the next 15 years was associated with a reduction in the incidence of IHD. In the older age group, 50–59 years, changing from a sedentary to a physically more active lifestyle during the next 15 years was associated with a doubled risk of IHD during the 6-year follow-up period compared with men at the same age who continued to be sedentary. Consequently, we advocate a thorough medical check-up before advising more physical activity in elderly men.
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