Circulation 2006 31;113:499-506
Li TY, Rana JS, Manson JE et al.
The comparative importance of physical inactivity and obesity as predictors of the risk of heart disease remains unsettled.
A team of doctors and scientists at the Harvard School of Public Health, Boston, USA followed 88 393 women, 34 to 59 years of age, in the Nurses' Health Study from 1980 to 2000. These participants did not have cardiovascular disease and/or cancer at the start of the study. They documented 2358 incident major cardiac events during 20 years of follow-up, including 889 cases of fatal heart attacks and 1469 cases of nonfatal heart attacks. Adjusting for other cardiovascular risk factors, overweight and obesity were significantly associated with increased risk of heart disease, whereas increasing levels of physical activity were associated with a graded reduction in risk.
Compared to women who had a healthy weight (BMI, 18.5 to 24.9 kg/m2) and were physically active (exercise > or =3.5 h/wk),
to suffer from a fatal or non-fatal heart attack.
Even a modest weight gain (4 to 10 kg) during adulthood was associated with 27% increased risk of heart disease compared with women with a stable weight after adjusting for physical activity and other cardiovascular risk factors.
The authors conclude that obesity and physical inactivity independently contribute to the development of heart disease in women. These data underscore the importance of both maintaining a healthy weight and regular physical activity in preventing heart attacks.
