Walking in the Prevention of Coronary Heart Disease

1
Walking in the Prevention of Coronary Heart
Disease

• Prepared by
• Don Hall, DrPH, CHES
• A Presentation of LifeLong Health

2
Physical Activity Level and Risk of Heart Attack
Relative Risk

• Nurses Health Study, 72,488 women followed for 8
  years
• The risk of heart attack decreased with
  increasing levels of physical activity
• Heart attack risk dropped over 50 in the most
  active women (top 20 compared to bottom 20)

NEJM, p.650, Aug. 26, 99
Little activity High activity
3
Relative Risk of Heart Attack by Quintile of
Physical Activity and Smoking Status
Relative Risk
Least active Most active Physical
Activity Level
NEJM, Aug. 26, 99
4
Relative Risk of Heart Attack by Quintile of
Physical Activity and Body Mass Index
Relative Risk
Least active Most
active Physical Activity Level
NEJM, Aug. 26, 99
5
Relative Risk of Heart Attack by Quintile of
Physical Activity and Family History of CHD
Relative Risk
Least active Most active Physical
Activity Level
NEJM, Aug. 26, 99
6
Walking Pace and Relative Risk of a Heart Attack

• Walking pace was another important determinant of
  risk of heart attack
• Women who walked at a moderate pace reduced risk
  by 25
• Women who walked briskly reduced risk by 36

NEJM, Aug. 26, 99
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Summary

• In this study, the reduction in risk of heart
  attack from brisk walking or vigorous activity
  were similar when total energy expenditures were
  similar
• Women who walk briskly for 3 or more hours per
  week can reduce their risk of a heart attack by
  30 to 40
• The researchers concluded that, one-third of
  coronary events (heart attacks) among middle-aged
  women in the United States are attributable to
  physical inactivity

NEJM, Aug. 26, 99
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Walking is Good Medicine

• When the weather will permit, all who can
  possibly do so ought to walk in the open air
  every day, summer and winter.
• A walk, even in winter, would be more beneficial
  to the health than all medicine the doctors may
  prescribe.

E.G. White, Counsels on Health, page 53, 1870