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(Circulation. 1999;100:2-4.)
© 1999 American Heart Association, Inc.

Editorial

Physical Inactivity

An Easily Modified Risk Factor?

Peter G. Snell, PhD; Jere H. Mitchell, MD

From the Moss Heart Center, University of Texas Southwestern Medical Center, Dallas, Tex.

Correspondence to Peter G. Snell, PhD, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-9034. E-mail psnell@mednet.swmed.edu

Key Words: Editorials • risk factors • exercise • mortality

The classic modifiable risk factors for the development of coronary heart disease (CHD), derived from the Framingham Heart Study and other long-term epidemiological studies, are increased blood pressure, elevated plasma cholesterol, and cigarette smoking. However, evidence has been accumulating for many years suggesting that physical inactivity or the lack of exercise is also a potent force in this field. The pioneering studies by Morris et al from England^{1 2} and Paffenbarger et al from the United States^{3 4} were the first to strongly suggest that increased physical activity, either at work or during leisure time, was a deterrent to the development of CHD. In 1953, Morris et al¹ studied transportation workers in London, England, and found that sedentary bus drivers had a greater incidence of CHD than the more active conductors on double-decker buses. Later, this group showed that vigorous leisure time activity also decreased the incidence of CHD.² In 1970, Paffenbarger et al³ examined the prevalence of CHD in San Francisco, Calif, longshoremen according to their levels of physical activity. They found that coronary death rates were lower in the middle- and high-activity groups than in the low-activity group.³ Subsequently, Paffenbarger et al⁴ used a questionnaire to determine the activity index of a large sample of Harvard University alumni and found a progressive decline in both fatal and nonfatal coronary events with an increasing activity index up to 2000 kcal/wk. Further activity had little additional effect on the incidence of CHD. For their similar independent studies, these 2 investigators were awarded . . . [Full Text of this Article]

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