title: Physical Activity and Vascular Events and Mortality in Patients with Vascular Disease.
abstract: BACKGROUND
  In patients with CAD, moderate levels of leisure time physical activity are associated with lower risk of mortality. However, less is known about the effects in patients with vascular disease other than CAD. In this study, we examined the association between physical activity and risk of future vascular events and all-cause mortality in patients with vascular disease or risk factors and investigated whether these associations were similar across the different manifestations of vascular disease.
  
  
  METHODS
  A total of 9942 consecutive patients with various manifestations of vascular disease or risk factors enroled in the Second Manifestations of ARTerial disease study were included. The amount of physical activity was assessed at baseline in MET-hours per week.
  
  
  RESULTS
  The study population (mean age, 56.7 yr; male, 67%) had a median level of physical activity of 17.4 MET·h·wk(-1). During a median follow-up of 6.7 yr, 1224 vascular events and 1353 cases of all-cause mortality were recorded. Cox regression analyses adjusted for age, sex, smoking, and current alcohol consumption showed that higher levels of physical activity were associated with reduced risk of vascular events (quartile 4 vs quartile 1; hazard ratio, 0.68 (95% confidence interval, 0.58-0.79)) and all-cause mortality (hazard ratio, 0.61 (95% confidence interval, 0.53-0.71)). This reduced risk was observed both in patients with vascular disease and in patients with risk factors. The associations were similar across the different manifestations of vascular disease.
  
  
  CONCLUSIONS
  Higher levels of leisure time physical activity were associated with reduced risk of vascular events and all-cause mortality in patients with CAD and other manifestations of vascular disease, suggesting that physical exercise programs should also be investigated in these other manifestations.
authors: 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, THE NETHERLANDS; 2Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, THE NETHERLANDS; 3Department of Neurology, University Medical Center Utrecht, Utrecht, THE NETHERLANDS; and 4Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, THE NETHERLANDS.
authors: H Myrthe
authors: HM
authors: Boss
authors: L Jaap
authors: LJ
authors: Kappelle
authors: Yolanda
authors: Y
authors: Van Der Graaf
authors: Minke
authors: M
authors: Kooistra
authors: Frank L J
authors: FL
authors: Visseren
authors: Mirjam I
authors: MI
authors: Geerlings
mesh_terms: D000368:Aged; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D014652:Vascular Diseases / Q000401:mortality*