title: Lifelong Exercise Patterns and Cardiovascular Health.
abstract: To determine the relationship between lifelong exercise dose and the prevalence of cardiovascular morbidity.
  
  
  
  From June 1, 2011, through December 31, 2014, 21,266 individuals completed an online questionnaire regarding their lifelong exercise patterns and cardiovascular health status. Cardiovascular disease (CVD) was defined as a diagnosis of myocardial infarction, stroke, or heart failure, and cardiovascular risk factors (CVRFs) were defined as hypertension, hypercholesterolemia, or type 2 diabetes. Lifelong exercise patterns were measured over a median of 32 years for 405 patients with CVD, 1379 patients with CVRFs, and 10,656 controls. Participants were categorized into nonexercisers and quintiles (Q1-Q5) of exercise dose (metabolic equivalent task [MET] minutes per week).
  
  
  
  The CVD/CVRF prevalence was lower for each exercise quintile compared with nonexercisers (CVD: nonexercisers, 9.6% vs Q1: 4.4%, Q2: 2.8%, Q3: 2.4%, Q4: 3.6%, Q5: 3.9%; P<.001; CVRF: nonexercisers, 24.6% vs Q1: 13.8%, Q2: 10.2%, Q3: 9.0%, Q4: 9.4%, Q5: 12.0%; P<.001). The lowest exercise dose (Q1) significantly reduced CVD and CVRF prevalence, but the largest reductions were found at 764 to 1091 MET-min/wk for CVD (adjusted odds ratio=0.31; 95% CI, 0.20-0.48) and CVRFs (adjusted odds ratio=0.36; 95% CI, 0.28-0.47). The CVD/CVRF prevalence did not further decrease in higher exercise dose groups. Exercise intensity did not influence the relationship between exercise patterns and CVD or CVRFs.
  
  
  
  These findings demonstrate a curvilinear relationship between lifelong exercise patterns and cardiovascular morbidity. Low exercise doses can effectively reduce CVD/CVRF prevalence, but engagement in exercise for 764 to 1091 MET-min/wk is associated with the lowest CVD/CVRF prevalence. Higher exercise doses do not yield additional benefits.
authors.affiliation: Department of Physiology, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Martijn F H
authors.initials: MF
authors.lastname: Maessen
authors.affiliation: Department of Health Evidence, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: André L M
authors.initials: AL
authors.lastname: Verbeek
authors.affiliation: Department of Physiology, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Health Evidence, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Esmée A
authors.initials: EA
authors.lastname: Bakker
authors.affiliation: Division of Cardiology, Hartford Hospital, Hartford, CT.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Thompson
authors.affiliation: Department of Physiology, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Maria T E
authors.initials: MT
authors.lastname: Hopman
authors.affiliation: Department of Physiology, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Division of Cardiology, Hartford Hospital, Hartford, CT; Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. Electronic address: Thijs.Eijsvogels@Radboudumc.nl.
authors.forename: Thijs M H
authors.initials: TM
authors.lastname: Eijsvogels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D002320:Cardiovascular Physiological Phenomena; D003924:Diabetes Mellitus, Type 2; D015444:Exercise / Q000502:physiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult