Heavy Physical Activity: Risk or Protective Factor for Cardiovascular Disease? A Life Course Perspective

Purpose The objective of this analysis was to examine the impact of lifetime physical activity (PA) on major cardiovascular disease. Methods At the baseline examination of the ESTHER study, a cohort study with 9953 participants, ages 50–74 years, with a lifetime history of PA and a physician-diagnosed myocardial infarction or stroke (major cardiovascular events, MCVE) were documented. The average number of hours per week of light and heavy PA (occupational and leisure time) between 20 and 50 years of age were calculated, and their association with the occurrence of MCVE after the age of 50 years was assessed by multiple logistic regression controlling for age, sex, smoking, body mass index, and education. Results A total of 569 study participants (6.1%) experienced a MCVE. Participants with no heavy PA at all or ≥40 hours per week had an increased risk for MCVE compared with study participants with PA up to 7 hours per week (odds ratios, 95% confidence intervals: 1.65, 1.10–2.46, and 1.69, 1.17–2.45, respectively). Conclusions Both absence and (typically occupation related) excess of heavy PA during adulthood seem to increase the risk of MCVE. Health effects of heavy PA are likely to be a matter of type and of dose.