1. 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
- Author
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Wang Chuangshi, Salim Yusuf, Romaina Iqbal, Amparo Casanova, Li Wei, Rafael Diaz, Danijela Gasevic, Ranjit Mohan Anjana, Koon K. Teo, Rajeev Gupta, Darryl P. Leong, Aytekin Oguz, Scott A. Lear, Pamela Seron, Liu Huaxing, Wang Yang, Weihong Hu, Katarzyna Zatońska, Paul Poirier, Annika Rosengren, Rajesh Kumar, Sanjeev Nair, Sumathy Rangarajan, Alvaro Avezum, Noushin Mohammadifard, Patricio Lopez-Jaramillo, Sumathi Swaminathan, and Hany Swidon
- Subjects
Adult ,Male ,Gerontology ,Developing country ,Population health ,030204 cardiovascular system & hematology ,Global Health ,Lower risk ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Environmental health ,Journal Article ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Mortality ,Prospective cohort study ,Developing Countries ,Exercise ,Recreation ,Aged ,Physical activity ,business.industry ,Developed Countries ,Hazard ratio ,General Medicine ,Middle Aged ,Cardiovascular disease ,Middle age ,Socioeconomic Factors ,Cardiovascular Diseases ,Female ,Rural area ,business - Abstract
7 p., Background: Physical activity has a protective effect against cardiovascular disease (CVD) in high-income countries, where physical activity is mainly recreational, but it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational. We examined whether different amounts and types of physical activity are associated with lower mortality and CVD in countries at different economic levels. Methods: In this prospective cohort study, we recruited participants from 17 countries (Canada, Sweden, United Arab Emirates, Argentina, Brazil, Chile, Poland, Turkey, Malaysia, South Africa, China, Colombia, Iran, Bangladesh, India, Pakistan, and Zimbabwe). Within each country, urban and rural areas in and around selected cities and towns were identified to reflect the geographical diversity. Within these communities, we invited individuals aged between 35 and 70 years who intended to live at their current address for at least another 4 years. Total physical activity was assessed using the International Physical Activity Questionnaire (IPQA). Participants with pre-existing CVD were excluded from the analyses. 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 (CVD mortality, incident myocardial infarction, stroke, or heart failure), either as a composite or separately. The effects of physical activity on mortality and CVD were adjusted for sociodemographic factors and other risk factors taking into account household, community, and country clustering. Findings: Between Jan 1, 2003, and Dec 31, 2010, 168 916 participants were enrolled, of whom 141 945 completed the IPAQ. Analyses were limited to the 130 843 participants without pre-existing CVD. Compared with low physical activity (3000 MET × minutes or >750 minutes per week) were associated with graded reduction in mortality (hazard ratio 0·80, 95% CI 0·74–0·87 and 0·65, 0·60–0·71; p
- Published
- 2017