Modelling the effects of increased physical activity on coronary heart disease in England and Wales.
OBJECTIVE
To investigate the use of computer models as tools for policy makers in evaluating physical activity interventions aimed at reducing deaths from coronary heart disease (CHD).


METHODS
The cell-based computer model Prevent, adapted to simulate risk factor interventions for an English and Welsh population, was used to simulate the effect of two strategies for increasing physical activity levels in respect of CHD mortality over 25 years. The first strategy involved a 25% increase in the proportion of 15-64 year olds who were moderately active, while the second strategy involved a similar increase in the proportion who were vigorously active. The effects of focusing on narrower age ranges and on people at different initial activity levels were also explored.


RESULTS
The simulations showed a small reduction in the CHD death rates--less than 0.15% and 0.06% for men and women respectively. The strategies would postpone up to 12,100 deaths over 25 years, comparable to the effect of a 2% reduction in smoking prevalence. The strategies seemed as if they would be more effective if they concentrated on men rather than women, on those over 45 years of age as opposed to all or younger age groups, and on the least active members of the population rather than those already taking some exercise.


CONCLUSIONS
The use of computer modelling for stimulating physical activity strategies has shown that concentrating these interventions on older sedentary men will produce the greatest health gain, but efforts to encourage smoking cessation may be more effective in terms of years of life saved.
Naidoo
B
B
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine.
Thorogood
M
M
McPherson
K
K
Gunning-Schepers
L J
LJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003198:Computer Simulation; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control*; D004739:England; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014852:Wales