Walking pace, leisure time physical activity, and resting heart rate in relation to disease-specific mortality in London: 40 years follow-up of the original Whitehall study. An update of our work with professor Jerry N. Morris (1910-2009).
OBJECTIVE
To examine the association of leisure time physical activity, walking pace and resting heart rate with disease-specific mortality in a prospective cohort study by reporting updated analyses of an earlier report we produced with the British epidemiologist, Jerry N. Morris (1910-2009).


METHODS
In the original Whitehall study, 19,019 male, nonindustrial, London-based government employees, aged from 40 to 69 years in 1967 and 1970, participated in a medical examination during which data on leisure time physical activity (N = 6715), self-rated walking pace (N = 6729), and resting heart rate (N = 1183) were collected. Cox proportional hazards analyses were used to estimate hazard ratios for the relation between these exposures and disease-specific mortality.


RESULTS
In models adjusted for a range of covariates including socioeconomic status, smoking, and obesity, high resting heart rate was associated with a modestly elevated rate of mortality from all causes (hazard ratio; 95% confidence interval: tertile 3 vs. tertile 1: 1.17; 0.99, 1.37 p[trend]: 0.07) and respiratory disease (1.69; 1.04, 2.76 p[trend]: 0.03). Of the two markers of physical activity, walking pace was inversely related to mortality ascribed to all causes (slow vs. high walking pace 1.71; 1.53, 1.91 p[trend]: <0.001]), coronary heart disease (2.03; 1.68, 2.47 p[trend]: <0.001), and total cancers (1.25; 0.98, 1.59 p[trend]: 0.04). The corresponding associations for leisure time activity were typically weaker. For other mortality endpoints-respiratory disease (walking pace: 1.96; 1.48, 2.60 p[trend]: <0.001]), hematopoietic cancer (walking pace: 1.36; 0.52, 3.51 p[trend]: 0.03), stomach cancer (inactive versus active leisure time: 1.53; 0.88, 2.64 p[trend]: 0.04), and rectal cancer (walking pace: 4.85; 1.70, 13.8 p[trend]: 0.007)-individual activity indices revealed effects, but not both.


CONCLUSIONS
Higher levels of physical activity indexed by the various markers herein appeared to confer protection against a range of mortality outcomes.
Batty
G David
GD
Medical Research Council Social and Public Health Sciences Unit, Glasgow, UK. david-b@sphsu.mrc.ac.uk
Shipley
Martin J
MJ
Kivimaki
Mika
M
Marmot
Michael
M
Davey Smith
George
G
D000328:Adult; D000368:Aged; D015415:Biomarkers; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000401:mortality; D004813:Epidemiology / Q000266:history; D006339:Heart Rate / Q000502:physiology*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011634:Public Health / Q000266:history; D012146:Rest / Q000502:physiology; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D016138:Walking / Q000266:history / Q000502:physiology*
D015415:Biomarkers