Diabetes and Cardiovascular Mortality:The Role of Physical Activity

• Main Author: Eilertsen, Eivin
• Format: Others
• Language: English
• Published: Norges teknisk-naturvitenskapelige universitet, Institutt for bevegelsesvitenskap 2010
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-11351

Background: An increased level of physical activity may reduce the risk of death from cardiovascular diseases (CVD), whilst diabetes increases risk of CVD mortality. However, whether physical activity may compensate for the adverse effects of diabetes remains to be investigated. Hence, the aim of this study is to assess the independent effect of diabetes and leisure time physical activity on CVD mortality, and also to examine the combined effect of leisure time physical activity and diabetes on risk of death from cardiovascular disease. Methods: The HUNT 2 study is the second wave of a large, population-based, longitudinal health study in the county of Nord-Trøndelag, Norway. A total of 59193 participants aged 20 years and older, without known cardiovascular diseases (CVD), were followed through a linkage with the Cause of Death Registry from baseline in 1995-1997 until the date of death, or until the end of follow-up December 31, 2005. 1537 individuals were defined as having diabetes at baseline. Hazard ratios (HRs) of death from CVD and ischemic heart disease (IHD) were estimated from Cox proportional hazard analysis with adjustment for potential confounding factors. Results: The HR of CVD death associated with diabetes was 1.94 (95% confidence interval (CI), 1.53-2.45) for men and 1.72 (95% CI, 1.33-2.22) for women. The corresponding risk of death from IHD was approximately two-fold, both in men and women. Participants who reported at least four hours of total physical activity each week had half the risk of CVD deaths compared to the least active. A similar effect was found for IHD mortality. In analysis of the combined effect, the least active persons with diabetes had more than twice the risk of death from CVD and IHD compared to the reference group of non-diabetic persons with the lowest activity level. On the other hand, individuals with diabetes who attended at least four hours of physical activity each week had a HR of 0.81 (95% CI, 0.41-1.63) for CVD mortality and 0.95 (95% CI, 0.35-2.59) for IHD mortality compared to the reference group. Conclusion: Persons with diabetes had approximately twice the risk for death from CVD and IHD compared to persons without diabetes. However, highly active people with diabetes had a risk of death that was equal to or even lower than the least active persons without diabetes, suggesting that high levels of physical activity may compensate for the risk-increasing effect of diabetes on cardiovascular mortality. Keywords: Diabetes ∙ Cardiovascular disease ∙ Ischemic heart disease ∙ Mortality ∙ Physical activity ∙ Follow-up