Physical activity and mortality in men and women with coronary heart disease: a prospective population-based cohort study in Norway (the HUNT study)

Background Patients with established coronary heart disease (CHD) are encouraged to be physically active to prevent disease progression and to prolong life. The amount and intensity of exercise required for risk reduction in patients with CHD is not yet fully resolved. Design Population-based prospective cohort study with 18 years of follow-up. Methods A linkage between a Norwegian population-based study (Nord-Trondelag health study) and the Cause of Death Registry at Statistics Norway. Exercise amount and intensity were measured at baseline (1984-1986) in 2137 men and 1367 women with CHD. Results During 18 years of follow-up, 1741 (81.6%) men and 1100 (80.5%) women died. Compared with the reference category (no activity), one weekly exercise session was associated with a lower all-cause mortality, both in men (relative risk 0.80, 95% confidence interval 0.68-0.94) and women (relative risk 0.68, 95% confidence interval 0.55-0.83). This inverse association became stronger with increasing frequency (P <= 0.001 for men and women). Those who reported moderate or high-intensity exercise had a somewhat lower risk of death than those who exercised with low intensity. Conclusion Exercise training reduced all-cause and cardiovascular mortality in men and women with CHD. This study adds significantly to the sparse literature regarding prospective data on physical activity, exercise intensity and mortality in CHD patients. Eur J Cardiovasc Prev Rehabil 15:639-645 (C) 2008 The European Society of Cardiology