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Staying moderately or more physically active at work appears to lower one’s risk of heart failure as much as leisure time activities, according to data published in the September 28, 2010, special prevention and outcomes focus issue of the Journal of the American College of Cardiology. This study also examines for the first time the role that commuting activity – daily walking or cycling to and from work – plays in protecting heart health.
Also reported in this issue is the most thorough systematic review and meta-analysis to date looking at the value of the metabolic syndrome in identifying patients at high cardiovascular risk. According to the report, people with the metabolic syndrome – defined by the National Cholesterol Education Program (NCEP) as having three or more cardiovascular risk factors including obesity (waistline >102 cm for men and >88 cm for women), high blood pressure, elevated blood sugar levels, high triglycerides and low HDL (or good) cholesterol – appear to be at substantially higher risk of dying or of having heart disease, a heart attack or a stroke than those without this syndrome, giving more credibility to this prognostic tool, which has been the focus of recent clinical debate.
Jobs that Require Workers to Be Active May Help Cut Their Risk of Heart Failure
New data finds that engaging in moderate or high levels of physical activity at work (e.g., standing, walking, heavy manual labor) appears to have the same protective effect on one’s risk of heart failure (HF) as leisure time activities, especially among men. Moreover, high levels of physical activity across the board -- during leisure time, at work and while commuting -- can cut the risk of HF by one third.
“The belief that only certain types of physical activity practiced during leisure time is beneficial for heart health is not correct,” said Gang Hu, M.D., Ph.D., assistant professor, Pennington Biomedical Research Center, Baton Rouge, LA and lead author of the study. “This study finds – for the first time – that occupational activity and daily walking or cycling to and from work are important components of a healthy lifestyle and in helping to prevent heart failure. Previous studies have only focused on leisure time activity.”
This study has important public health implications in light of the increasing number of sedentary workers due to the rise in computerization and mechanization of the workplace. In fact, the World Heart Federation has designated their 2010 World Heart Day theme “Workplace Wellness,” to draw attention to the benefits associated with employee health programs and provide tools and tips for improving workday health and fitness behaviors.
“Adding short bouts of exercise during work breaks, walking or cycling to and from work, and adding leisure time physical activity are recommended,” said Dr. Hu. “Health care providers should be aware of the importance of any type of physical activity.”
Authors found that people who engage in two or three types of physical activity (on the job, while commuting and during leisure time) had a slightly stronger protective effect than participation in only one type of physical activity.
This study involved more than 62,000 Finish men and women between the ages of 25 and 74 years of age who were free of heart failure at baseline and followed for an average of 18.4 years. Baseline measures of different types of physical activity were used to predict HF; other risk factors were collected and adjusted for (e.g., age, smoking, body mass index, blood pressure, cholesterol). HF developed in 1,868 men and 1,640 women.
Having “Metabolic Syndrome” Greatly Increases Risk of Heart-related Problems, Even Death, Study Finds
In recent years, the prognostic value of the metabolic syndrome—a clustering of cardiovascular risk factors estimated to affect one in four people in North America—has been hotly debated. This latest analysis, which includes more than 70 new studies and a total of nearly one million patients, sought to shed light on the issue by quantifying how much the metabolic syndrome increases one’s risk of heart-related events and death.
People who meet the standard criteria for the metabolic syndrome as defined by NCEP have up to two and a half times the risk of dying of heart-related causes and of having heart disease, a heart attack or a stroke than people without the syndrome, according to the study. These patients also have a 50 percent greater risk of dying during follow up. Even people without diabetes remained at high cardiovascular risk.
“Our study suggests that the association between metabolic syndrome and cardiovascular outcomes is even stronger than previously suspected,” said Mark Eisenberg, M.D., M.P.H., professor of medicine, Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, Canada and author of the study. “It firmly reinforces the urgent need to aggressively combat the metabolic syndrome in order to reduce and perhaps even prevent heart disease and improve survival.”
Prevention strategies at the patient level include routine checkups to closely track cardiovascular risk factors, lifestyle modification such as diet and exercise, and, if needed, medication therapy. But amid the growing obesity epidemic and increasing numbers of people with the metabolic syndrome, authors emphasize the need for population-level prevention too.
“Ultimately, population-level interventions such as New York City’s ban on trans-fats are needed to decrease the number of people with the metabolic syndrome and their corresponding cardiovascular risk,” said Dr. Eisenberg.
Authors say future studies are needed to determine whether the metabolic syndrome is more predictive than the individual cardiovascular risk factors and to better understand why the risk of heart disease associated with the metabolic syndrome differs in men and women.
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The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The College is a 39,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at www.cardiosource.org.