Occupational and Leisure Time Physical Activity, Fitness, Coronary Heart Disease, and 22-Year Mortality: Results from the Kuopio Ischemic Heart Disease Risk Factor Study

Details

• Personal Author:
  Arah O ; Kauhanen J ; Krause N
• Description:
  Aim: The aim of this study was to assess prospectively the independent effects of occupational physical activity (OPA) and conditioning leisure time physical activity (LTPA) on atherosclerosis, coronary heart disease (CHD) and mortality among 1861 working middle-aged Finnish men with and without CHD at baseline. Methods: Fitness (VO2max), OPA (work posture, energy expenditure, relative aerobic workload), conditioning LTPA, cardiovascular disease (CVD) status and potential confounders were assessed at baseline. Repeat ultrasound measures of carotid artery intima media thickness and national hospitalisation and death registry data were used to determine progression of atherosclerosis, incidence of acute myocardial infarction (AMI) and all-cause and CHD mortality during up to 27 years of follow-up. Relative hazards with 95% confidence intervals were estimated in Cox regression models incrementally adjusting for 18 demographic, biological, behavioural, socioeconomic and psychosocial factors. Interaction effects were determined followed by analyses stratified by baseline CHD. Result: A predominantly standing work posture was associated with (up to ninefold) accelerated four-year progression of carotid artery intima media thickness compared to no standing work; effects were strongest among men with CHD at baseline and effect sizes were comparable to smoking. Energy expenditure at work and relative aerobic workload were positively associated with 20-year incidence of AMI and 22-year all-cause and CHD mortality. Among men without CHD, each 10% increase of relative aerobic workload increased AMI risk by 18% (hazard ratio (HR) 1.18, 95% confidence interval (CI) 1.08-1.28, P¼0.001), all-cause mortality by 15% (HR 1.15, 95% CI 1.07-1.24, P¼0.000) and CHD mortality by 30% (HR 1.30, 95% CI 1.14-1.49, P¼0.000). Among men with CHD the risk increases were 8%, 11% and 19%, respectively. LTPA was not associated with progression of atherosclerosis or incidence of AMI. LTPA also had no effect on mortality among healthy men but was positively associated with all-cause and CHD mortality among men with baseline CHD: each weekly hour of conditioning LTPA increased all-cause mortality risks by 10% (HR 1.10, 95% CI 1.03-1.18, P¼0.005) and CHD mortality by 14% (HR 1.14, 1.04-1.26, P¼0.08). These results were adjusted for age, body mass index, blood glucose, plasma fibrinogen, low-density lipoprotein and high-density lipoproteincholesterol, participation in a lipid-lowering drug trial, lipid-lowering and anti-hypertensive medication, systolic blood pressure, alcohol, smoking, personal income, social support at work, mental strain at work, stress from work deadlines and LTPA or OPA. Conclusion: Conditioning LTPA did not reduce CVD risk and, among men with CHD, increased mortality risk. Prolonged standing at work accelerated the progression of atherosclerosis, especially in men with CHD. High levels of OPA in terms of energy expenditure, especially if measured as relative aerobic workload taking individual fitness into account, were associated with elevated risks of AMI incidence and all-cause and CHD mortality. Future research, CVD risk assessment and physical activity recommendations need to differentiate between OPA and LTPA and take interactions with individual fitness and cardiovascular health status into account. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Men Mortality Occupational Health Safety
• Keywords:
  Activity Levels Cardiovascular Disease Intervention Mortality Rates Occupational Health Physical Exercise Psychosocial Factors
• ISSN:
  2047-4873
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  11-12
• Volume:
  24
• Issue:
  2
• NIOSHTIC Number:
  nn:20055738
• Citation:
  Eur J Prev Cardiol 2017 May; 24(2)(Suppl):11-12
• Federal Fiscal Year:
  2017
• Performing Organization:
  University of California Los Angeles
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  European Journal of Preventive Cardiology
• Supplement:
  Supplement
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a794b5ff0a2ac4c6b85690849b6797913b347708cb718fc5f6961cd13c274853071fe44b0bf8e9f2d179c1986ca510d043a626ddc194e71f4a1fee92f297df07
• Download URL:
  https://stacks.cdc.gov/view/cdc/213519/cdc_213519_DS1.pdf
• File Type:
  [PDF - 33.50 KB ]