Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes.
OBJECTIVE
The aim of this study was to examine both single and joint associations of physical activity and conventional cardiovascular risk factors with total and cardiovascular mortality among patients with diabetes.


METHODS
We prospectively followed 3,708 Finnish patients with type 2 diabetes aged 25-74 years. Physical activity, smoking status, blood pressure, height, weight, and serum cholesterol level were determined at baseline. Cox proportional hazard models were used to estimate single and joint effects of physical activity and other cardiovascular risk factors on the risk of mortality.


RESULTS
During a mean follow-up of 18.7 years, 1,423 deaths were recorded, 906 of which were due to cardiovascular disease. Moderate or high levels of physical activity were associated with decreased total and cardiovascular mortality, whereas higher levels of BMI and blood pressure and current smoking were associated with increased total and cardiovascular mortality. High serum cholesterol levels also increased cardiovascular mortality. The protective effect of physical activity was consistent in diabetic patients with any levels of BMI, blood pressure, total cholesterol, and smoking.


CONCLUSIONS
A moderate or high level of physical activity was associated with a reduced risk of total and cardiovascular mortality among patients with type 2 diabetes. The favorable association of physical activity with longevity was observed regardless of the levels of BMI, blood pressure, total cholesterol, and smoking.
Hu
Gang
G
Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland. hu.gang@ktl.fi
Jousilahti
Pekka
P
Barengo
Noël C
NC
Qiao
Qing
Q
Lakka
Timo A
TA
Tuomilehto
Jaakko
J
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001835:Body Weight; D002784:Cholesterol; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D015444:Exercise; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D010809:Physical Fitness; D012307:Risk Factors; D012907:Smoking; D016019:Survival Analysis
D002784:Cholesterol