Association of Physical Activity and Lower Respiratory Tract Infection Outcomes in Patients With Cardiovascular Disease

Abstract

Background To investigate the dose‐response association between physical activity and lower respiratory tract infection ( LoRI ) outcomes in patients with cardiovascular disease. Methods and Results Using the Korean National Health Insurance data, we identified individuals aged 18 to 99 years (mean age, 62.6±11.3 years; women, 49.6%) with cardiovascular disease who participated in health screening from January 1, 2009, to December 31, 2012 (n=1 048 502), and were followed up until 2018 for mortality and until 2019 for hospitalization. Amount of physical activity was assessed using self‐reported questionnaires and categorized into 5 groups: 0 (completely sedentary), <500, 500 to 999, 1000 to 1499, and ≥1500 metabolic equivalents of task min/wk. After controlling for various confounders, adjusted hazard ratios (95% CIs) were 1.00 (reference), 0.74 (0.70–0.78), 0.66 (0.62–0.70), 0.52 (0.47–0.57), and 0.54 (0.49–0.60) for LoRI mortality, and 1.00 (reference), 0.84 (0.83–0.85), 0.77 (0.76–0.79), 0.72 (0.70–0.73), and 0.71 (0.69–0.73) for LoRI hospitalization among those engaging in physical activity of 0, <500, 500 to 999, 1000 to 1499, and ≥1500 metabolic equivalents of task min/wk, respectively. Assuming linear association between 0 and 2000 metabolic equivalents of task min/wk, each 500–metabolic equivalents of task min/wk increase of physical activity was associated with reduced LoRI mortality and hospitalization by 22% and 13%, respectively. The negative association was stronger in the older population than in the younger population ( P for interaction <0.01). Conclusions In patients with cardiovascular disease, engaging in even a low level of physical activity was associated with a decreased risk of mortality and hospitalization from LoRI than being completely sedentary, and incremental risk reduction was observed with increased physical activity.

Physical activity lowers the risk for acute respiratory infections: Time for recognition

“…Numerous epidemiological studies have focused on the relationship between MVPA and pneumonia. 8 , 10 , [11] , [12] , [13] , [14] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] A review of 10 prospective cohort studies with over one million participants concluded that the risk for pneumonia (incidence and mortality) was 31% lower when comparing the most and least physically active groups. 32 These findings have been extended to those with diabetes 9 and cardiovascular disease (CVD).…”

“… 32 These findings have been extended to those with diabetes 9 and cardiovascular disease (CVD). 43 A large population-based cohort study with more than one million Korean patients with CVD demonstrated a negative dose-response association of MVPA on mortality and hospitalization attributable to lower respiratory tract infections (LRTI), including pneumonia, bronchitis, and tuberculosis. 43 Each 500-MET min/week increase of MVPA was associated with a 22% and 13% reduced risk of LRTI mortality and hospitalization, respectively.…”

Exercise sustains the hallmarks of health

“… 77 Even low levels of physical activity in older patients with cardiovascular disease are associated with decreased mortality and hospitalization from pneumonia. 78 Thus, exercise training has been recommended to support pulmonary rehabilitation in chronic disease management. 79 …”

Multiple Biological Mechanisms for the Potential Influence of Phytochemicals on Physical Activity Performance: A Narrative Review

“…Although moderate exercise increases immunity, more intense regimens can cause temporary dips in immunity, increasing the risk of viral infections [4,119]. Upper respiratory tract viral infections are a significant cause of breaks in training and can result in the cancellation of a much-anticipated sporting event [120,121]. As well as being uncomfortable, intense exercise during a cold or flu infection is unwise as it can be associated with acute virus-induced skeletal and heart muscle damage, so it is not wise to train during the infective period [120].…”