More physical activity lowers mortality in patients with stable CHD
Increasing physical activity appears to reduce mortality in patients with stable coronary heart disease (CHD), with the largest benefits occurring between sedentary patient groups and between those with the highest mortality risk, a recent study suggests.
Patients from 39 countries with stable CHD (n=15,486) who participated in the STABILITY* study completed questions at baseline on hours spent each week doing mild, moderate and vigorous exercise. Researchers investigated the associations between the volume of habitual exercise in metabolic equivalents of task hours/week and adverse outcomes during a median 3.7 years of follow-up.
There was a graded decrease in mortality with more habitual exercise that was steeper at lower compared with higher exercise levels. In addition, doubling exercise volume was likely to lower all-cause mortality (unadjusted hazard ratio [HR], 0.82; 95 percent CI, 0.79 to 0.85; adjusting for covariates: HR, 0.90; 0.87 to 0.93).
Such associations were also observed in cardiovascular mortality (unadjusted HR, 0.83; 0.80 to 0.87; adjusted HR, 0.92; 0.88 to 0.96). However, after adjusting for covariates, myocardial infarction and stroke did not correlate with exercise volume.
The benefit of reduced mortality with more physical activity was stronger in the subgroup of patients at higher risk estimated by the ABC-CHD (Age, Biomarkers, Clinical‒Coronary Heart Disease) risk score (p=0.0007 for interaction).
An earlier international study of patients with chronic CHD participating in the STABILITY study found that cardiovascular symptoms partially explained low physical activity. Researchers further stated that potentially modifiable societal and health system factors are important determinants of physical inactivity in patients with chronic CHD. [Eur Heart J 2013;34:3286-93]
*Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy