Physical Activity in Relation to Cardiovascular Disease and Total Mortality Among Men With Type 2 Diabetes

Abstract

Background-The present study was conducted to examine the relationship of physical activity with risk of cardiovascular disease (CVD) and mortality among men with type 2 diabetes. CVD risk and mortality are increased in type 2 diabetes. Few epidemiological studies have investigated the effect of physical activity on these outcomes among type 2 diabetics. Methods and Results-Of the 3058 men who reported a diagnosis of diabetes at age 30 years or older in the Health Professionals' Follow-up Study (HPFS), we excluded 255 who reported a physical impairment. In the remaining 2803 men, physical activity was assessed every 2 years; 266 new cases of CVD and 355 deaths of all causes were identified during 14 years of follow-up. Relative risks of CVD and death were estimated from Cox proportional hazards analysis with adjustment for potential confounders. The multivariate relative risks of CVD incidence corresponding to quintiles of total physical activity were 1.0, 0.87, 0.64, 0.72, and 0.67 (P trend ϭ0.07). The corresponding multivariate relative risks for total mortality were 1.0, 0.80, 0.57, 0.58, and 0.58 (P trend ϭ0.005). Walking was associated with reduced risk of total mortality. Relative risks across quintiles of walking were 1.0, 0.97, 0.87, 0.97, and 0.57 (P trend ϭ0.002). Walking pace was inversely associated with CVD, fatal CVD, and total mortality independently of walking hours. Conclusions-Physical activity was associated with reduced risk of CVD, cardiovascular death, and total mortality in men with type 2 diabetes. Walking and walking pace were associated with reduced total mortality. (Circulation. 2003;107: 2435-2439.)

Physical Activity and Risk of All-Cause and Cardiovascular Disease Mortality in Diabetic Adults From Great Britain: Pooled Analysis of 10 Population-Based Cohorts

“…Our data on the protective effects of walking for all-cause and CVD mortality are consistent with recent literature (8)(9)(10)34,35). However, most previous studies have examined the effects of higher doses of walking.…”

“…For example, in a previous study (9) individuals who walked $2 h/week had a 39% lower risk of all-cause mortality (22-52%) and a 44% lower risk of CVD mortality (4-55%) compared with those reporting no walking. Another study (10) found that diabetic patients classified in the top quintile ($16.1 MET-hours/week) of walking from a large U.S. cohort had a 43% lower risk of all-cause mortality (17-41%). Our results expand on these findings by suggesting that, even when other physical activity is taken into account, low doses of walking (0.1-5.3 MET-hours/week, corresponding roughly to 1.5-1.7 h of walking) were still beneficially associated with all-cause mortality among male patients with diabetes.…”

“…Prospective cohort studies have shown that diabetic patients who engage in regular physical activity have a lower risk of CVD and all-cause mortality than those who are less active (7)(8)(9)(10)(11)(12)(13)(14)(15). Randomized controlled trials of structured exercise training among diabetic patients have shown the beneficial effects on insulin sensitivity, glycemic control, and weight loss or maintenance (16)(17)(18)(19)(20)(21), although behavioral interventions designed to deliver physical activity advice did not demonstrate a significant benefit compared with usual care (21).…”

The adverse association of diabetes with risk of first acute myocardial infarction is modified by physical activity and body mass index: prospective data from the HUNT Study, Norway

“…Similar to the present study, previous studies have shown that diabetes increases the risk of AMI [3][4][5], with a stronger association in women than in men [4,5], and that the most physically active people with diabetes have approximately half the risk of cardiovascular death compared with inactive people with diabetes [24,25]. Moreover, we have recently shown that physical activity modified the association between diabetes and mortality [26].…”

Effect of High-Intensity Exercise on Endothelial Function in Patients With T2dm

“…Endothelial function is a precocious marker of cardiovascular disease. But, although this study didn't evaluate long term issues, it is justified in the literature that intense exercise reduces cardiovascular risk [36][37][38][39] . Ostergard et al 40 is that the vascular function can improve at the beginning of the study and to begin a worsening after some weeks of intervention with exercise of high intensity, fact not noticed in our study, although with a time of intervention of six weeks.…”