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Cited by 1,052Physical Activity and HealthCardiovascular and exercise physiologyCardiovascular Effects of Exercise

Dose Response Between Physical Activity and Risk of Coronary Heart Disease: A Meta-Analysis

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Sattelmair, Jacob, Pertman, Jeremy, Ding, Eric L., Kohl, Harold W., Haskell, William, Lee, I-Min·2011·Circulation
DOI 10.1161/circulationaha.110.010710PMC PMC3158733
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Abstract

Background: No reviews have quantified the specific amounts of physical activity required for lower risks of coronary heart disease when assessing the dose-response relation. Instead, previous reviews have used qualitative estimates such as low, moderate, and high physical activity. Methods and Results: We performed an aggregate data meta-analysis of epidemiological studies investigating physical activity and primary prevention of CHD. We included prospective cohort studies published in English since 1995. After reviewing 3194 abstracts, we included 33 studies. We used random-effects generalized least squares spline models for trend estimation to derive pooled dose-response estimates. Among the 33 studies, 9 allowed quantitative estimates of leisure-time physical activity. Individuals who engaged in the equivalent of 150 min/wk of moderate-intensity leisure-time physical activity (minimum amount, 2008 US federal guidelines) had a 14% lower coronary heart disease risk (relative risk, 0.86; 95% confidence interval, 0.77 to 0.96) compared with those reporting no leisure-time physical activity. Those engaging in the equivalent of 300 min/wk of moderate-intensity leisure-time physical activity (2008 US federal guidelines for additional benefits) had a 20% (relative risk, 0.80; 95% confidence interval, 0.74 to 0.88) lower risk. At higher levels of physical activity, relative risks were modestly lower. People who were physically active at levels lower than the minimum recommended amount also had significantly lower risk of coronary heart disease. There was a significant interaction by sex ( P =0.03); the association was stronger among women than men. Conclusions: These findings provide quantitative data supporting US physical activity guidelines that stipulate that “some physical activity is better than none” and “additional benefits occur with more physical activity.”

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  • There is voluminous evidence that risks of remaining physically inactive, especially in those with chronic disease, are substantial.

    “There is voluminous evidence that risks of remaining physically inactive, especially in those with chronic disease, are substantial (38,45).”

    From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [38]

    The Introduction describes substantial evidence linking physical activity with lower coronary heart disease risk, and the Discussion reports lower risk even at modest activity levels. But the paper addresses coronary heart disease risk, not the risks of inactivity generally; its Methods also exclude studies in which all participants had diabetes from the main analysis, so it does not establish the claim’s emphasis on people with chronic disease. The indexed passages have section labels but no page numbers. (LLM, conf=0.88)

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Research works printed but not linked: 35

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Authors
Sattelmair, J., Pertman, J., Ding, E. L., Kohl, H. W., Haskell, W., & Lee, I.-M.
Affiliations
Brigham and Women's Hospital (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-08-16
Volume
124
Issue
7
Pages
789-795
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.110.010710
PMC
PMC3158733
OpenAlex
W2089408935
Cited by
1,052
References
16
Citations by year
2026: 34 · 2025: 54 · 2024: 73 · 2023: 54 · 2022: 83 · 2021: 74 · 2020: 75 · 2019: 96 · 2018: 82 · 2017: 86 · 2016: 85 · 2015: 75 · 2014: 72 · 2013: 53 · 2012: 43
FWCI
37.96
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (T32HL007575)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Keywords
physical activity, coronary artery disease, dose-response relationship, leisure-time physical activity, moderate-intensity exercise, physical activity guidelines, sex differences, primary prevention, cardiovascular risk
MeSH terms
Coronary Disease, Humans, Motor Activity, Physical Fitness, Public Health, Risk Factors, Guidelines as Topic, Risk Reduction Behavior

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