Effects of Walking on Coronary Heart Disease in Elderly Men
To The Editor:
The recent article by Hakim et al1 reports a beneficial effect of walking on coronary heart disease in elderly men; this has important clinical implications regarding physical activity as a modifiable risk factor.
To help isolate the independent effect of distance walked on coronary heart disease, subtle statistical analyses were done; these showed no significant association with major and minor cardiovascular risk factors, such as high cholesterol levels, hypertension, smoking, diabetes, and alcohol intake.
Recently, the Nutrition Committee of the American Heart Association strongly suggested that obesity be upgraded from the status of a contributing risk factor to that of a major risk factor for coronary heart disease.2 There is compelling evidence that obesity, over the long term, increases Medicare costs and the risks of morbidity, such as stroke, coronary heart disease, or diabetes mellitus.3 Lack of physical activity could be at least one possible explanation for the exaggerated rate of cardiovascular events in obese patients.
If the body mass index is available for all study subjects, we think that the database of this trial provides an excellent opportunity to calculate the association between obesity and distance walked.
- Copyright © 2000 by American Heart Association
Hakim AA, Curb JD, Petrovitch H, et al. Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. Circulation. 1999;100:9–13.
Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease: AHA Nutrition Committee. Circulation. 1998;97:2099–2100.
Van Itallie T. Health implications of overweight and obesity in the United States. Ann Intern Med. 1985;103:983–988.