Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Physical Activity & Risk of Mortality & CVD
Lancet; 2017 Dec 16; Lear, Rangarajan, et al
Among a large cohort of people from 17 high-income, middle-income, and low-income countries, higher recreational and non-recreational physical activity was associated with a lower risk of mortality and cardiovascular disease (CVD) events, a recent study found. The prospective cohort study included 130,000 participants from 17 countries (aged 35 to 70 years) who intended to live at their current address for at least another 4 years. Mortality and CVD were recorded during a mean of 6.9 years of follow-up. Primary clinical outcomes during follow-up were mortality plus major CVD. Researchers found:
- Compared with low physical activity (<150 minutes per week of moderate intensity physical activity), moderate (150-750 minutes per week) and high physical activity (>750 minutes per week) were associated with graded reduction in mortality (HR, 0.80), and major CVD (HR, 0.86).
- Higher physical activity was associated with lower risk of CVD and mortality in high-income, middle-income, and low-income countries.
- Both recreational and non-recreational activity were associated with benefits.
Lear SA, Rangarajan S, Gasevic D, et al. The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet. 2017;390:2643-2654. doi:10.1016/S0140-6736(17)31634-3.
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Physical Activity & Incidence of CHD & CVD in Women, JAMA Netw Open; ePub 2019 Mar 15; LaCroix, et al
The health challenges of the next 50 years include increasing rates of obesity, diabetes, coronary artery disease, and stroke, all of which are influenced by lifestyle choices with regard to diet and physical activity. This study gives further support, across countries and across the range of socioeconomic regions, that increased physical activity leads to lower mortality. The incremental benefit of physical activity was greatest comparing modest physical activity with low physical activity, with those who engaged in modest physical activity having a 20% lower rate of mortality compared to those who had low physical activity. Higher levels of physical activity have increasingly greater effect on improvement in mortality. It does not seem to matter who you get physical activity through work or recreation, but activity leads to better health and lower mortality. As the New Year approaches and it is again time for resolutions that we make and break, it is important to think about re-committing to a regular exercise program and helping both ourselves and our patients by thinking ahead of ways we might sustain that commitment over the course of the year. —Neil Skolnik, MD