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Physical Activity/Glycemic Control Predicts CV Death and All-cause Mortality

Physical activity is associated with lower all-cause and CVD mortality risk for individuals across all levels of glycemic control.

Therefore, engaging in a physically active lifestyle and achieving normal levels of glycemic control may both be important for the prevention of early mortality.

The sample included 10,352 adults from the Third National Health and Nutrition Examination Survey (NHANES III) Linked Mortality Public-use File (follow-up 13.4±3.9 years; 2,463 deaths). Physical activity was assessed by questionnaire and classified into inactive and active categories based on self-reported frequency of leisure-time activity. HbA1c was categorized to reflect the American Diabetes Association diagnostic and treatment guidelines.

The results showed that, being physically active was associated with a decreased risk of all-cause (HR 0.74 [95% CI 0.67, 0.81]) and CVD (HR 0.71 [95% CI 0.62, 0.82]) mortality, whereas higher levels of HbA1c were associated with an increased mortality risk. Plus, HbA1c ≥7% (53 mmol/mol) was associated with the highest risk for all-cause (HR 1.54 [95% CI 1.30, 1.82]) and CVD (HR 1.93 [95% CI 1.52, 2.45]) mortality.

Across all categories of HbA1c, active individuals were not at increased risk for all-cause mortality compared with inactive individuals with normal glycemic control. Similar findings were observed for CVD mortality, except that active individuals with HbA1c ≥7% (53 mmol/mol) were still at increased risk for CVD mortality. Their risk for CVD death was substantially lower than the risk for their inactive counterparts (HR 1.38 [95% CI 1.03, 1.84] vs. HR 1.98 [95% CI 1.34, 2.92]).

The joint association of physical activity and glycemic control in predicting cardiovascular death and all-cause mortality in the US population. Diabetologia – Clinical and Experimental Diabetes and Metabolism, 11/18/2011