Movement and circulation: Population studies on physical activitiy and cardiovascular disease risk.

The relationship of leisure-time physical activity with cardiovascular risk factors and mortality was determined using data from the German Cardiovascular Prevention Study, conducted from 1984-1991. Three nationally representative crosssectional samples, with a total of 7 689 men and 7 747 women, ages 25-69, were part of this study, originally designed to estimate the impact of community intervention on cardiovascular health. Additionally we analyzed regional cross-sectional and follow-up samples.Physically active individuals were more often urbanized, more likely to have high socioeconomic status, less often smokers and had healthier eating patterns and lower body mass index. Compared with sedentary individuals, the most active quartile of men (>18 kcal/kg/week spent on conditioning activities) had significantly favorable levels of serum total cholesterol (-2.5%), HDL/total cholesterol ratio (+4.2%) and resting heart rate (-4.3%). The most active women (>12 kcal/kg/week) had significantly better HDL cholesterol (+3.7%), HDL/total cholesterol ratio (+3.9%), triglycerides (-5.1%), diastolic (-1.3%) and systolic (-1.6%) blood pressure, body mass index (-2.8%) and resting heart rate (-2.5%). With duration and intensity constant, significantly better risk factor levels were observed with increased frequency of physical activity. For active men, we observed a relative risk of 0.33 (95% CI 0.11-0.94) for cardiovascular disease mortality and of 0.67 (95% CI 0.36-1.25) for all-cause mortality (5-8 year follow-up) compared with the least actives, independent of baseline risk factor levels. The elderly (ages 50-69) showed substantial benefits from participation in light to moderate activities, such as walking and cycling, most apparent when conducted frequently (≥5 times/week). Using data from the Spandau Health Test (1827 men and 2 929 women, ages 40-80, followed from 1982-1994) we estimated an all-cause mortality relative risk of 1.7 (95% CI 1.4-2.2) for men and 1.4 (95% CI 1.1-1.8) for women for each 20 beats/min higher resting heart rate.More than 40% of German adults are sedentary. We recommend them regularly, preferably daily, to conduct moderately intense activities, such as brisk walking, running, swimming or cycling, for at least 30 minutes. Elderly may prefer light activities, such as walking or gardening. An active lifestyle may substantially improve the cardiovascular risk profile of the German population. For example, if only 50% of sedentary German men, ages 40-69, would become modestly active more than 6 500 cardiovascular deaths could be prevented each year