Walking and sports participation and mortality from coronary heart disease and stroke.

OBJECTIVES We aimed to examine the impact of exercise on mortality from cardiovascular disease (CVD) in Asian populations. BACKGROUND Few data have been available in Asian countries, where job-related physical activity is higher than that in Western countries. METHODS Between 1988 and 1990, 31,023 men and 42,242 women in Japan, ages 40 to 79 years with no history of stroke, coronary heart disease (CHD), or cancer, completed a self-administered questionnaire. Systematic mortality surveillance was performed through 1999, and 1,946 cardiovascular deaths were identified. We chose the second lowest categories of walking and sports participation as the reference to reduce a potential effect of ill health. RESULTS Men and women who reported having physical activity in the highest category (i.e., walking > or =1 h/day or doing sports > or =5 h/week) had a 20% to 60% lower age-adjusted risk of mortality from CVD, compared with those in the second lowest physical activity category (i.e., walking 0.5 h/day, or sports participation for 1 to 2 h/week). Adjustment for known risk factors, exclusion of individuals who died within two years of baseline inquiry, or gender-specific analysis did not substantially alter these associations. The multivariate-adjusted hazard ratios (95% confidence interval) for the highest versus the second lowest categories of walking or sports participation were 0.71 (0.54 to 0.94) and 0.80 (0.48 to 1.31), respectively, for ischemic stroke (IS); 0.84 (0.64 to 1.09) and 0.51 (0.32 to 0.82), respectively, for CHD; and 0.84 (0.75 to 0.95) and 0.73 (0.60 to 0.90), respectively, for CVD. CONCLUSIONS Physical activity through walking and sports participation might reduce the risk of mortality from IS and CHD.