Walking Reduces Risk of CVD,
CV Death and Total Mortality in Diabetic Men &
Women
Two studies validate that walking was associated
with reduced CVD risk and total mortality for
Men and Women with type 2 diabetes.
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.
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=0.07). The corresponding
multivariate relative risks for total mortality
were 1.0, 0.80, 0.57, 0.58, and 0.58 (P trend=0.005).
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=0.002). Walking pace was inversely associated
with CVD, fatal CVD, and total mortality independently
of walking hours.
From the results of the study it was concluded
that 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.
In the second study, they used 5125 female nurses
with diabetes In the Nurses' Health Study.
The objective of the study was to determine whether
physical activity decreases risk for cardiovascular
disease among diabetic women.
Physical activity was first assessed in 1980
and was updated in 1982, 1986, 1988, and 1992
through validated questionnaires. Average hours
of moderate or vigorous exercise and a metabolic
equivalent of task (MET) score were computed.
During 14 years of follow-up (31 432 person-years),
323 new cases of cardiovascular disease were documented
(225 cases of coronary heart disease and 98 cases
of stroke). The age-adjusted relative risks according
to average hours of moderate or vigorous activity
per week were 1.0, 0.93, 0.82, 0.54, and 0.52.
These figures did not change materially after
adjustment for smoking, body mass index, and other
cardiovascular risk factors (1.0, 1.02, 0.87,
0.61, and 0.55, respectively; P = 0.001 for trend).
In separate analyses, levels of physical activity
were inversely associated with coronary heart
disease and ischemic stroke. Among women who did
not exercise vigorously, the multivariate relative
risks for cardiovascular disease across quartiles
of MET score for walking were 1.0, 0.85, 0.63,
and 0.56 (P = 0.03 for trend). Faster usual walking
pace was independently associated with lower risk.
From the results it was concluded that among
diabetic women, increased physical activity, including
regular walking, is associated with substantially
reduced risk for cardiovascular events. Ann Intern
Med. 2001;134:96-105.
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