Leisure-Time Physical Activity and Cardiovascular Mortality in an Elderly Population in Northern Manhattan: A Prospective Cohort Study

Abstract

<div class="section"> <a class="named-anchor" id="d3682374e207"> <!-- named anchor --> </a> <h5 class="section-title" id="d3682374e208">Background</h5> <p id="Par1">Previous studies of exercise have focused on measuring physical activity in totality using summary statistics such as metabolic equivalent score for total intensity or total energy count. </p> </div><div class="section"> <a class="named-anchor" id="d3682374e212"> <!-- named anchor --> </a> <h5 class="section-title" id="d3682374e213">Objective</h5> <p id="Par2">We aimed to examine the multidimensionality of leisure-time physical activity (LTPA) and to identify the specific LTPA components that were associated with cardiovascular mortality in the elderly. </p> </div><div class="section"> <a class="named-anchor" id="d3682374e217"> <!-- named anchor --> </a> <h5 class="section-title" id="d3682374e218">Design and Participants</h5> <p id="Par3">The Northern Manhattan Study (NOMAS) is a multiethnic prospective cohort of elderly stroke-free individuals consisting of a total of 3298 participants recruited between 1993 and 2001, with a median follow-up of 17 years. </p> </div><div class="section"> <a class="named-anchor" id="d3682374e222"> <!-- named anchor --> </a> <h5 class="section-title" id="d3682374e223">Main Measures</h5> <p id="Par4">Physical activity questionnaire data were available in 3293 NOMAS participants, who were categorized into subgroups with similar exercise patterns by model-based cluster analysis. Three subgroup-defining LTPA features were identified and were considered as primary exposures in Cox proportional hazard models: frequency of activity, number of activity types (variety), and energy-to-duration ratio (EDR). We considered cardiovascular mortality and non-cardiovascular mortality as outcomes in Cox cause-specific proportional hazard models, and all-cause mortality as outcome in Cox models. </p> </div><div class="section"> <a class="named-anchor" id="d3682374e227"> <!-- named anchor --> </a> <h5 class="section-title" id="d3682374e228">Key Results</h5> <p id="Par5">A high activity frequency was associated with reduced cardiovascular mortality (hazard ratio, HR = 0.93, <i>P</i> = 0.03), but demonstrated no effect on non-cardiovascular death. A high EDR was associated with increased risk of cardiovascular death (HR = 1.30, <i>P</i> = 0.01). A high number of activity types was beneficial in reducing all-cause mortality (HR = 0.87, <i>P</i> = 0.01). </p> </div><div class="section"> <a class="named-anchor" id="d3682374e241"> <!-- named anchor --> </a> <h5 class="section-title" id="d3682374e242">Conclusions</h5> <p id="Par6">Exercise frequency was protective against cardiovascular mortality, and a high variety of activity was protective against all-cause mortality. The performance of frequent and varied non-intense exercise in an elderly population such as ours is achievable and can reduce the risk of death. </p> </div>