Fitness, work, and leisure-time physical activity and ischaemic heart disease and all-cause mortality among men with pre-existing cardiovascular disease.
OBJECTIVE
Our aim was to study the relative impact of physical fitness, physical demands at work, and physical activity during leisure time on ischaemic heart disease (IHD) and all-cause mortality among employed men with pre-existing cardiovascular disease (CVD).


METHODS
We carried out a 30-year follow-up of the Copenhagen Male Study of 274 gainfully employed men, aged 40-59 years who had a history of CVD (ie, myocardial infarction, angina pectoris, and intermittent claudication). We estimated physical fitness [maximal oxygen consumption (VO (2)Max)] using the Astrand cycling test and determined physical work demands and leisure-time physical activity using a self-reported questionnaire. Results Among 274 men with a history of CVD, 93 men died from IHD. Using male employees with a history of CVD and a low level of fitness as the reference group, our Cox analyses - adjusted for age, blood pressure, smoking, alcohol consumption, body mass index, diabetes, hypertension, physical work demands, leisure-time physical activity, and social class - showed a substantially reduced risk for IHD mortality among employees who were intermediately fit [VO (2)Max range 25-36; hazard ratio (HR) 0.54, 95% confidence interval (95% CI) CI 0.32-0.93] and highly fit (VO (2)Max range 37-50; HR 0.28, 95% CI 0.12-0.66). We found a positive, but statistically non-significant association between physical demands at work and all-cause mortality.


CONCLUSIONS
Among gainfully employed men with pre-existing CVD, a high physical fitness was associated with a substantially reduced risk for IHD and all-cause mortality.
Holtermann
Andreas
A
National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark. aho@nrcwe.dk
Mortensen
Ole Steen
OS
Burr
Hermann
H
Søgaard
Karen
K
Gyntelberg
Finn
F
Suadicani
Poul
P
D000328:Adult; D000428:Alcohol Drinking; D000787:Angina Pectoris / Q000453:epidemiology / Q000401:mortality; D015992:Body Mass Index; D016001:Confidence Intervals; D003718:Denmark / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007383:Intermittent Claudication / Q000453:epidemiology / Q000401:mortality; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000401:mortality*; D016272:Occupational Health; D010101:Oxygen Consumption; D010809:Physical Fitness; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014937:Work