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A Prospective Study of Walking as Compared with Vigorous Exercise in the Prevention of Coronary Heart Disease in Women
Open accessAbstract
BACKGROUND: The role of walking, as compared with vigorous exercise, in the prevention of coronary heart disease remains controversial, and data for women on this topic are sparse. METHODS: We prospectively examined the associations between the score for total physical activity, walking, and vigorous exercise and the incidence of coronary events among 72,488 female nurses who were 40 to 65 years old in 1986. Participants were free of diagnosed cardiovascular disease or cancer at the time of entry and completed serial detailed questionnaires about physical activity. During eight years of follow-up, we documented 645 incident coronary events (nonfatal myocardial infarction or death from coronary disease). RESULTS: There was a strong, graded inverse association between physical activity and the risk of coronary events. As compared with women in the lowest quintile group for energy expenditure (expressed as the metabolic-equivalent [MET] score), women in increasing quintile groups had age-adjusted relative risks of 0.77, 0.65, 0.54, and 0.46 for coronary events (P for trend <0.001). In multivariate analyses, the inverse gradient remained strong (relative risks, 0.88, 0.81, 0.74, and 0.66 for women in increasing quintile groups as compared with those in the lowest quintile group; P for trend=0.002). Walking was inversely associated with the risk of coronary events; women in the highest quintile group for walking, who walked the equivalent of three or more hours per week at a brisk pace, had a multivariate relative risk of 0.65 (95 percent confidence interval, 0.47 to 0.91) as compared with women who walked infrequently. Regular vigorous exercise (> or =6 MET) was associated with similar risk reductions (30 to 40 percent). Sedentary women who became active in middle adulthood or later had a lower risk of coronary events than their counterparts who remained sedentary. CONCLUSIONS: These prospective data indicate that brisk walking and vigorous exercise are associated with substantial and similar reductions in the incidence of coronary events among women.
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“Moderate physical activity is associated with a markedly reduced risk of coronary events 32,36 and cardiac arrest, 37 and therefore it might also protect against sudden death.”
From Triggering of Sudden Death from Cardiac Causes by Vigorous Exertion (2000) · cites this paper as [32]
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L’activité physique : un élément clef de la prévention primaire cardiovasculaire
Brion, R. (2011) · Archives des Maladies du Coeur et des Vaisseaux - Pratique · doi:10.1016/s1261-694x(11)70254-1 · Cited by 3
Chesler, R., Goldberg, N., & Stein, R. (2009) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-009-0033-8 · Cited by 1
“Gulati et al. [7] confi rmed the inverse relationship between exercise capacity and cardiovascular mortality in asymptomatic and symptomatic women and used their data to construct a nomogram that predicted survival (Table 1). Two additional landmark investigations were based on the Framingham Heart Study [8]: the Nurs…”
MethodFarias, E. D. S., Mendivil, F. H. D. S., & Guerra-Júnior, G. (2008) · doi:10.4025/reveducfis.v19i4.4655 · Cited by 1
Motivation to Exercise: Translating Our Best Intentions into Action
Carpenter, C. (2008) · Obesity Management · doi:10.1089/obe.2008.0244 · Cited by 1
홍, 혜., 박, 진., & Kang, H. (2008) · Exercise Science · doi:10.15857/ksep.2008.17.4.483 · Cited by 1
Kwak, Y.-S., & Kim, D.-J. (2008) · Journal of Life Science · doi:10.5352/jls.2008.18.5.715 · Cited by 1
Effectiveness of Low-Intensity Endurance Training
Meyer, T., Auracher, M., Heeg, K., Urhausen, A., & Kindermann, W. (2006) · International Journal of Sports Medicine · doi:10.1055/s-2006-924037 · Cited by 1
Diet and heart health: emerging evidence – a multidisciplinary approach*
Sadler, M. (2003) · Nutrition Bulletin · doi:10.1046/j.1467-3010.2003.00296.x · Cited by 1
Bertram, R., Cordes, C., Schmidt, S., Lorig, K., Delille, G., & Mertens, H. (2002) · Medizinische Klinik · doi:10.1007/s00063-002-1126-z · Cited by 1
Cardiac rehabilitation: exercising the heart
Jackson, G. (2000) · International journal of clinical practice · doi:10.1111/j.1742-1241.2000.tb11849.x · Cited by 1
Ramírez-Verdugo, M. D., & López, M. (2020) · Advances in higher education and professional development book series · doi:10.4018/978-1-7998-4697-0.ch006 · Cited by 2
BGM 4.0 – Intelligente Vernetzung in der VUKA-Welt
Lotzmann, N. (2019) · Springer eBooks · doi:10.1007/978-3-662-59044-7_26 · Cited by 2
García, C. M. (2015) · doi:10.35537/10915/46494 · Cited by 1
DeLegge, M. H., & Keith, J. N. (2012) · Springer eBooks · doi:10.1007/978-1-4419-1710-2_3
Exercise as an Approach to Obesity and the Metabolic Syndrome
Jakicic, J., & Otto, A. D. (2006) · Springer eBooks · doi:10.1007/978-0-387-32164-6_12 · Cited by 1
“Moreover, data from the Nurses’ Health Study indicate that regular exercise that is ≥ 6 METS is associated with a 30 to 40 reduction in coronary heart disease in women [ 7 ], which is similar to the results reported by Hu et al. [10].”
Result
Metadata
- Authors
- Manson, J. E., Hu, F. B., Rich-Edwards, J. W., Colditz, G. A., Stampfer, M. J., Willett, W. C., Speizer, F. E., & Hennekens, C. H.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1999-08-26
- Volume
- 341
- Issue
- 9
- Pages
- 650-658
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2330716957
- Cited by
- 1,005
- References
- 0
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 14 · 2023: 21 · 2022: 16 · 2021: 20 · 2020: 24 · 2019: 25 · 2018: 31 · 2017: 33 · 2016: 28 · 2015: 32 · 2014: 41 · 2013: 40 · 2012: 48
- FWCI
- 26.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL34594, R01HL034594)
- National Cancer Institute (CA-40356)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- walking, high-intensity exercise, coronary heart disease prevention, women, physical activity, energy expenditure, myocardial infarction, coronary events, sedentary lifestyle, midlife
- MeSH terms
- Adult, Aged, Coronary Disease, Energy Metabolism, Female, Humans, Middle Aged, Prospective Studies, Risk, Exercise, Incidence, Multivariate Analysis, Walking
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