The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study
Open accessAbstract
Background Physical activity has a protective effect against cardiovascular disease (CVD) in high-income countries, where physical activity is mainly recreational, but it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational. We examined whether different amounts and types of physical activity are associated with lower mortality and CVD in countries at different economic levels.Methods In this prospective cohort study, we recruited participants from 17 countries (Canada, Sweden, United Arab Emirates, Argentina, Brazil, Chile, Poland, Turkey, Malaysia, South Africa, China, Colombia, Iran, Bangladesh, India, Pakistan, and Zimbabwe). Within each country, urban and rural areas in and around selected cities and towns were identified to reflect the geographical diversity. Within these communities, we invited individuals aged between 35 and 70 years who intended to live at their current address for at least another 4 years. Total physical activity was assessed using the International Physical Activity Questionnaire (IPQA). Participants with pre-existing CVD were excluded from the analyses. Mortality and CVD were recorded during a mean of 6·9 years of follow-up. Primary clinical outcomes during follow-up were mortality plus major CVD (CVD mortality, incident myocardial infarction, stroke, or heart failure), either as a composite or separately. The effects of physical activity on mortality and CVD were adjusted for sociodemographic factors and other risk factors taking into account household, community, and country clustering.Findings Between Jan 1, 2003, and Dec 31, 2010, 168 916 participants were enrolled, of whom 141 945 completed the IPAQ. Analyses were limited to the 130 843 participants without pre-existing CVD. Compared with low physical activity (<600 metabolic equivalents [MET] × minutes per week or <150 minutes per week of moderate intensity physical activity), moderate (600-3000 MET × minutes or 150-750 minutes per week) and high physical activity (>3000 MET × minutes or >750 minutes per week) were associated with graded reduction in mortality (hazard ratio 0·80, 95% CI 0·74-0·87 and 0·65, 0·60-0·71; p<0·0001 for trend), and major CVD (0·86, 0·78-0·93; p<0·001 for trend). Higher physical activity was associated with lower risk of CVD and mortality in high-income, middle-income, and low-income countries. The adjusted population attributable fraction for not meeting the physical activity guidelines was 8·0% for mortality and 4·6% for major CVD, and for not meeting high physical activity was 13·0% for mortality and 9·5% for major CVD. Both recreational and non-recreational physical activity were associated with benefits.Interpretation Higher recreational and non-recreational physical activity was associated with a lower risk of mortality and CVD events in individuals from low-income, middle-income, and high-income countries. Increasing physical activity is a simple, widely applicable, low cost global strategy that could reduce deaths and CVD in middle age.Funding Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, Ontario SPOR Support Unit, Ontario Ministry of Health and Long-Term Care, AstraZeneca, Sanofi-Aventis, Boehringer Ingelheim, Servier, GSK, Novartis, King Pharma, and national and local organisations in participating countries that are listed at the end of the Article.
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International physical activity questionnaire: 12-country reliability and validity
CRAIG, C. L., MARSHALL, A. L., SJ??STR??M, M., BAUMAN, A. E., BOOTH, M. L., AINSWORTH, B. E., PRATT, M., EKELUND, U., YNGVE, A., SALLIS, J. F., et al. (2003) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000078924.61453.fb · Cited by 21,619 · see citing works
Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17018-9 · Cited by 12,026 · see citing works
Self-citationRegression Modeling Strategies
Harrell, F. E. (2001) · Springer series in statistics · doi:10.1007/978-1-4757-3462-1 · Cited by 9,270 · see citing works
Lee, I.-M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., & Katzmarzyk, P. T. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61031-9 · Cited by 8,215 · see citing works
Some Methods for Strengthening the Common χ 2 Tests
Cochran, W. G. (1954) · Biometrics · doi:10.2307/3001616 · Cited by 3,718 · see citing works
Tests for Linear Trends in Proportions and Frequencies
Armitage, P. (1955) · Biometrics · doi:10.2307/3001775 · Cited by 2,092 · see citing works
Rao, S. J. (2003) · Journal of the American Statistical Association · doi:10.1198/jasa.2003.s263 · Cited by 1,986 · see citing works
(2012) · RePEc: Research Papers in Economics · Cited by 1,951 · see citing works
A DISTRIBUTION-FREE k -SAMPLE TEST AGAINST ORDERED ALTERNATIVES
Jonckheere, A. R. (1954) · Biometrika · doi:10.1093/biomet/41.1-2.133 · Cited by 1,513 · see citing works
Arem, H., Moore, S. C., Patel, A., Hartge, P., Berrington de Gonzalez, A., Visvanathan, K., Campbell, P. T., Freedman, M., Weiderpass, E., Adami, H. O., et al. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.0533 · Cited by 1,498 · see citing works
Sjöström, M., Ainsworth, B., Bauman, A. E., Bull, F., Hamilton-Craig, C., & Sallis, J. F. (2005) · Cited by 1,403 · see citing works
Demographic and epidemiologic drivers of global cardiovascular mortality
Roth, G. A., Forouzanfar, M. H., Moran, A. E., Barber, R., Nguyen, G., Feigin, V. L., Naghavi, M., Mensah, G. A., & Murray, C. J. L. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1406656 · Cited by 1,188 · see citing works
Nocon, M., Hiemann, T., Müller-Riemenschneider, F., Thalau, F., Roll, S., & Willich, S. N. (2008) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e3282f55e09 · Cited by 1,080 · see citing works
Strath, S. J., Kaminsky, L. A., Ainsworth, B. E., Ekelund, U., Freedson, P. S., Gary, R. A., Richardson, C. R., Smith, D. T., & Swartz, A. M. (2013) · Circulation · doi:10.1161/01.cir.0000435708.67487.da · Cited by 1,029 · see citing works
Progress in physical activity over the Olympic quadrennium
Sallis, J. F., Bull, F., Guthold, R., Heath, G. W., Inoue, S., Kelly, P., Oyeyemi, A. L., Perez, L. G., Richards, J., & Hallal, P. C. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30581-5 · Cited by 935 · see citing works
The International Prevalence Study on Physical Activity: results from 20 countries
Bauman, A. E., Bull, F., Chey, T., Craig, C. L., Ainsworth, B. E., Sallis, J. F., Bowles, H. R., Hagströmer, M., Sjöstróm, M., Pratt, M., et al. (2009) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-6-21 · Cited by 934 · see citing works
Reis, R. S., Salvo, D., Ogilvie, D., Lambert, E. V., Goenka, S., & Brownson, R. C. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30728-0 · Cited by 719 · see citing works
Moore, S. C., Patel, A. V., Matthews, C. E., Berrington de Gonzalez, A., Park, Y., Katki, H. A., Linet, M. S., Weiderpass, E., Visvanathan, K., Helzlsouer, K. J., et al. (2012) · PLoS Medicine · doi:10.1371/journal.pmed.1001335 · Cited by 690 · see citing works
Lee, E. W., Wei, L. J., Amato, D. A., & Leurgans, S. (1992) · Survival Analysis: State of the Art · doi:10.1007/978-94-015-7983-4_14 · Cited by 688 · see citing works
Self-citationTeo, K. K., Chow, C. K., Vaz, M. A. P., Rangarajan, S., & Yusuf, S. (2009) · American Heart Journal · doi:10.1016/j.ahj.2009.04.019 · Cited by 603 · see citing works
Self-citationCox regression analysis of multivariate failure time data: The marginal approach
Lin, D. Y. (1994) · Statistics in Medicine · doi:10.1002/sim.4780132105 · Cited by 588 · see citing works
The Global Burden of Disease Study and the Preventable Burden of NCD
Benziger, C. P., Roth, G. A., & Moran, A. E. (2016) · Global Heart · doi:10.1016/j.gheart.2016.10.024 · Cited by 547 · see citing works
Kelly, P., Kahlmeier, S., Götschi, T., Orsini, N., Richards, J. A., Roberts, N. W., Scarborough, P., & Foster, C. E. (2014) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-014-0132-x · Cited by 518 · see citing works
Terpstra, T. J. (1952) · Indagationes Mathematicae (Proceedings) · doi:10.1016/s1385-7258(52)50043-x · Cited by 502 · see citing works
Miller, V., Yusuf, S., Chow, C. K., Dehghan, M., Corsi, D. J., Lock, K., Popkin, B. M., Rangarajan, S., Khatib, R., Lear, S. A., et al. (2016) · The Lancet Global Health · doi:10.1016/s2214-109x(16)30186-3 · Cited by 455 · see citing works
Self-citationKhatib, R., McKee, M., Shannon, H. S., Chow, C. K., Rangarajan, S., Teo, K. K., Li, W., Mony, P. K., Mohan, V., Gupta, R., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00469-9 · Cited by 393 · see citing works
Self-citationMatthews, C., Jurj, A. L., Shu, X., Li, H.-L., Yang, G., Li, Q., Gao, Y.-T., & Zheng, W. (2007) · American Journal of Epidemiology · doi:10.1093/aje/kwm088 · Cited by 362 · see citing works
Global public health: a scorecard
Beaglehole, R., & Bonita, R. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61558-5 · Cited by 212 · see citing works
Survival Analysis: State of the Art
(1992) · Springer eBooks · doi:10.1007/978-94-015-7983-4 · Cited by 206 · see citing works
Association between domains of physical activity and all-cause, cardiovascular and cancer mortality
Autenrieth, C. S., Baumert, J. J., Baumeister, S. E., Fischer, B., Peters, A., Döring, A., & Thorand, B. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9517-6 · Cited by 196 · see citing works
Changes in physical activity and all-cause mortality in COPD
Vaes, A. W., García‐Aymerich, J., Marott, J. L., Benet, M., Groenen, M. T. J., Schnohr, P., Franssen, F. M. E., Vestbo, J., Wouters, E. F. �., Lange, P., et al. (2014) · European Respiratory Journal · doi:10.1183/09031936.00023214 · Cited by 192 · see citing works
Corsi, D. J., Subramanian, S. V., Chow, C. K., McKee, M., Chifamba, J., Dagenais, G., Díaz, R., Iqbal, R., Kelishadi, R., Kruger, A., et al. (2013) · American Heart Journal · doi:10.1016/j.ahj.2013.04.019 · Cited by 155 · see citing works
Self-citationWanner, M., Probst-Hensch, N. M., Kriemler, S., Meier, F., Autenrieth, C. S., & Martin, B. W. (2016) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2016.03.003 · Cited by 140 · see citing works
Sabia, S., Dugravot, A., Mika Kivimaki, B., Brunner, E. J., Shipley, M. J., & Singh‐Manoux, A. (2011) · American Journal of Public Health · doi:10.2105/ajph.2011.300257 · Cited by 117 · see citing works
Relationship between Subdomains of Total Physical Activity and Mortality
Besson, H., Ekelund, U., Brage, S., Luben, R., Bingham, S. A., Khaw, K., & Wareham, N. J. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318180bcad · Cited by 106 · see citing works
Gajalakshmi, V., Peto, R., Kanaka, S., & Balasubramanian, S. (2002) · BMC Public Health · doi:10.1186/1471-2458-2-7 · Cited by 101 · see citing works
HU, G., Jousilahti, P., Antikaínen, R., & Tuomilehto, J. O. (2007) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2007.07.015 · Cited by 89 · see citing works
Milton, K. E., Macniven, R., & Bauman, A. E. (2014) · Global Public Health · doi:10.1080/17441692.2014.894548 · Cited by 75 · see citing works
Attributable fraction functions for censored event times
Chen, L., Lin, D. Y., & Zeng, D. (2010) · Biometrika · doi:10.1093/biomet/asq023 · Cited by 58 · see citing works
Wu, C., Hu, H., Chou, Y. C., Huang, N., Chou, Y., & Li, C. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2014.12.023 · Cited by 52 · see citing works
Etemadi, A., Abnet, C. C., Kamangar, F., Islami, F., Khademi, H., Pourshams, A., Poustchi, H., Bagheri, M., Sohrabpour, A. A., Aliasgar, A., et al. (2014) · European Journal of Epidemiology · doi:10.1007/s10654-014-9883-6 · Cited by 43 · see citing works
Housework Reduces All-Cause and Cancer Mortality in Chinese Men
Yu, R., Leung, J. C. S., & Woo, J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0061529 · Cited by 38 · see citing works
Johnsen, A. M., Alfredsson, L. S., Knutsson, A., Westerholm, P. J. M., & Fransson, E. I. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-012692 · Cited by 34 · see citing works
Nathaniel Schenker, A., Parsons, V. L., Lochner, K. A., Wheatcroft, G., & Pamuk, E. R. (2011) · Statistics in Medicine · doi:10.1002/sim.4219 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
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Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000757 · Cited by 9,175 · see citing works
Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000659 · Cited by 9,036 · see citing works
Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001123 · Cited by 8,300 · see citing works
Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001052 · Cited by 5,987 · see citing works
2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease
Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J.-P., Corrado, D., Drezner, J. A., Halle, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa605 · Cited by 1,958 · see citing works
Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., Whincup, P., Diaz, K. M., Hooker, S. P., Chernofsky, A., et al. (2019) · BMJ · doi:10.1136/bmj.l4570 · Cited by 1,769 · see citing works
Effects of stress on the development and progression of cardiovascular disease
Kivimäki, M., & Steptoe, A. (2018) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2017.189 · Cited by 1,197 · see citing works
Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors
Fiuza-Luces, C., Santos-Lozano, A., Joyner, M., Carrera-Bastos, P., Picazo, O., Zugaza, J. L., Izquierdo, M., Ruilope, L. M., & Lucia, A. (2018) · Nature Reviews Cardiology · doi:10.1038/s41569-018-0065-1 · Cited by 803 · see citing works
Franklin, B. A., Thompson, P. D., Al-Zaiti, S. S., Albert, C. M., Hivert, M.-F., Levine, B. D., Lobelo, F., Madan, K., Sharrief, A. Z., Eijsvogels, T. M. H., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000749 · Cited by 410 · see citing works
Laranjo, L., Ding, D., Heleno, B., Kocaballi, B., Quiroz, J. C., Tong, H. L., Chahwan, B., Neves, A. L., Gabarron, E., Dao, K. P., et al. (2021) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-102892 · Cited by 400 · see citing works
Holtermann, A., Schnohr, P., Nordestgaard, B. G., & Marott, J. L. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab087 · Cited by 341 · see citing works
Kivimäki, M., Singh-Manoux, A., Pentti, J., Sabia, S., Nyberg, S. T., Alfredsson, L., Goldberg, M., Knutsson, A., Koskenvuo, M., Koskinen, A., et al. (2019) · BMJ · doi:10.1136/bmj.l1495 · Cited by 313 · see citing works
Fitbit-based interventions for healthy lifestyle outcomes: systematic review and meta-analysis
Ringeval, M., Wagner, G., Denford, J., Paré, G., & Kitsiou, S. (2020) · Journal of Medical Internet Research · doi:10.2196/23954 · Cited by 225 · see citing works
“These public health problems are associated with mental health problems, cardiovascular diseases, and shorter life expectancies [5-8].”
BackgroundIntegrating the environmental and genetic architectures of aging and mortality
Argentieri, M. A., Amin, N., Nevado-Holgado, A. J., Sproviero, W., Collister, J. A., Keestra, S. M., Kuilman, M. M., Ginos, B. N. R., Ghanbari, M., Doherty, A., et al. (2025) · Nature Medicine · doi:10.1038/s41591-024-03483-9 · Cited by 211 · see citing works
Blond, K., Brinkløv, C. F., Ried-Larsen, M., Crippa, A., & Grøntved, A. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2018-100393 · Cited by 201 · see citing works
Global environmental change and noncommunicable disease risks
Frumkin, H., & Haines, A. (2019) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-040218-043706 · Cited by 194 · see citing works
LaCroix, A. Z., Bellettiere, J., Rillamas-Sun, E., Di, C., Evenson, K. R., Lewis, C. E., Buchner, D. M., Stefanick, M. L., Lee, I.-M., Rosenberg, D. E., et al. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.0419 · Cited by 162 · see citing works
Stensvold, D., Viken, H., Steinshamn, S. L., Dalen, H., Støylen, A., Loennechen, J. P., Reitlo, L. S., Zisko, N., Bækkerud, F. H., Tari, A. R., et al. (2020) · BMJ · doi:10.1136/bmj.m3485 · Cited by 154 · see citing works
Rogers, N. T., Waterlow, N. R., Brindle, H., Enria, L., Eggo, R. M., Lees, S., & Roberts, C. H. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.575091 · Cited by 140 · see citing works
Physical activity and mortality: what is the dose response and how big is the effect?
Ekelund, U., Dalene, K. E., Tarp, J., & Lee, I.-M. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-101765 · Cited by 90 · see citing works
Management of Obesity in Cardiovascular Practice
Després, J.-P., Carpentier, A. C., Tchernof, A., Neeland, I. J., & Poirier, P. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.05.035 · Cited by 87 · see citing works
Self-citationChen, L.-J., Hamer, M., Lai, Y.-J., Huang, B.-H., Ku, P.-W., & Stamatakis, E. (2022) · Journal of Sport and Health Science · doi:10.1016/j.jshs.2021.03.001 · Cited by 82 · see citing works
Ho, F. K., Zhou, Z., Petermann-Rocha, F., Para-Soto, S., Boonpor, J., Welsh, P., Gill, J. M. R., Gray, S. R., Sattar, N., Pell, J. P., et al. (2022) · Circulation · doi:10.1161/circulationaha.122.059663 · Cited by 76 · see citing works
Physical activity and fitness in the community: the Framingham Heart Study
Nayor, M., Chernofsky, A., Spartano, N. L., Tanguay, M., Blodgett, J. B., Murthy, V. L., Malhotra, R., Houstis, N. E., Velagaleti, R. S., Murabito, J. M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab580 · Cited by 78 · see citing works
Henry, A., Paik, J. M., Austin, P., Eberly, K. E., Golabi, P., Younossi, I., Henry, L., Gerber, L., & Younossi, Z. M. (2023) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17308 · Cited by 61 · see citing works
Physical activity and longevity: how to move closer to causal inference
Wade, K. H., Richmond, R. C., & Davey Smith, G. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098995 · Cited by 57 · see citing works
Koh, S.-H., Choi, S. H., Jeong, J. H., Jang, J.-W., Park, K. W., Kim, E.-J., Kim, H. J., Hong, J. Y., Yoon, S. J., Yoon, B., et al. (2020) · Aging · doi:10.18632/aging.102893 · Cited by 51 · see citing works
Barbosa, A., Whiting, S., Ding, D., Brito, J., & Mendes, R. (2022) · European Journal of Public Health · doi:10.1093/eurpub/ckac074 · Cited by 23 · see citing works
Chen, X.-K., Zheng, C., Wong, S. H.-S., & Ma, A. C.-H. (2022) · Aging · doi:10.18632/aging.204458 · Cited by 10 · see citing works
Typical everyday movements cause specific patterns in heart rate
Heidelbach, M. J., Cysarz, D., & Edelhäuser, F. (2024) · Frontiers in Physiology · doi:10.3389/fphys.2024.1379739 · Cited by 5 · see citing works
- Authors
- Lear, S. A., Hu, W., Rangarajan, S., Gasevic, D., Leong, D., Iqbal, R., Casanova, A., Swaminathan, S., Anjana, R. M., Kumar, R., Rosengren, A., Wei, L., Yang, W., Chuangshi, W., Huaxing, L., Nair, S., Diaz, R., Swidon, H., Gupta, R., Mohammadifard, N., Lopez-Jaramillo, P., Oguz, A., Zatonska, K., Seron, P., Avezum, A., Poirier, P., Teo, K., & Yusuf, S.
- Affiliations
- Providence Health Care (CA)
- Population Health Research Institute (CA)
- Aga Khan University (PK)
- St. John's National Academy of Health Sciences (IN)
- Madras Diabetes Research Foundation (IN)
- Post Graduate Institute of Medical Education and Research (IN)
- University of Gothenburg (SE)
- Fu Wai Hospital (CN)
- Government Medical College (IN)
- Dubai Health Authority (AE)
- Isfahan University of Medical Sciences (IR)
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Corresponding author
- Lear, Scott A
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 390
- Issue
- 10113
- Pages
- 2643-2654
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2758276259
- Cited by
- 1,331
- References
- 45
- Citations by year
- 2026: 114 · 2025: 144 · 2024: 172 · 2023: 152 · 2022: 186 · 2021: 176 · 2020: 181 · 2019: 130 · 2018: 64 · 2017: 9
- FWCI
- 77.67
- Type
- journal article
- Language
- en
- Open access
- green
- ecommons.aku.edu
- Licence
- cc-by-nc-sa
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion, cc-by-nc-sa)
- Repositorio Universidad de Santander (submittedVersion, cc-by-nc)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Funders
- Pfizer
- Heart and Stroke Foundation of Canada
- Ontario Ministry of Health and Long-Term Care
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- physical activity, cardiovascular disease, mortality, cardiovascular mortality, myocardial infarction, stroke, heart failure, moderate physical activity, low-income countries, socioeconomic status, urban-rural differences, PURE study, metabolic equivalents, cardiovascular risk reduction, physical activity guidelines
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Developing Countries, Female, Humans, Male, Middle Aged, Mortality, Prospective Studies, Risk Factors, Socioeconomic Factors, Global Health, Exercise, Developed Countries
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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