Physical activity and vascular disease in a prospective cohort study of older men: the Health In Men Study (HIMS)

Lacey, Ben, Golledge, Jonathan, Yeap, Bu B., Lewington, Sarah, Norman, Paul E., Flicker, Leon, Almeida, Osvaldo P., and Hankey, Graeme J. (2015) Physical activity and vascular disease in a prospective cohort study of older men: the Health In Men Study (HIMS). BMC Geriatrics, 15. 164. pp. 1-9.

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Background: The dose–response relationship between volume of physical activity and incidence of major vascular events at older age is unclear. We aimed to investigate this association in a cohort of older men.

Methods: For this prospective cohort study, 7564 men aged 65–83 years and without prior vascular disease were recruited in 1996–99 from the general population in Perth, Western Australia. Men were followed up using the Western Australian Data Linkage System to identify deaths and hospitalisations. During mean follow-up of 11 (SD 4) years, there were 1557 first major vascular events: 833 ischaemic heart disease events, 551 stroke events and 173 other vascular events. Cox regression was used to calculate hazard ratios (adjusted for age, education and smoking) for incidence of major vascular events by volume of baseline recreational physical activity (measured in metabolic equivalent [MET] hours per week).

Results: Hazard ratios among men who performed 0, 1–14, 15–24, 25–39, ≥40 MET-hours per week of recreational physical activity were 1.00 (95 % CI 0.91–1.10; referent), 0.88 (0.79–1.00), 0.81 (0.72–0.91), 0.81 (0.72–0.91) and 0.80 (0.71–0.89), respectively (P trend =0.006). The association was slightly attenuated with further adjustment for BMI. There was evidence of stronger associations at older ages and greater intensity of activity, but no evidence of effect modification by smoking, alcohol intake or BMI. There was also no evidence that the association varied by type of vascular event.

Conclusions: Among men aged over 65 years, there was a curvilinear association between recreational physical activity and incidence of major vascular events, with an inverse association up to about 20 MET-hours per week (equivalent to 1 h of non-vigorous, or half an hour of vigorous, physical activity per day) and no evidence of further reductions in risk thereafter.

Item ID: 44464
Item Type: Article (Research - C1)
ISSN: 1471-2318
Keywords: epidemiology, cardiovascular diseases, exercise
Additional Information:

© 2015 Lacey et al. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Funders: National Health and Medical Research Council (NHMRC), Queensland Government, Townsville Hospital Private Practice Trust, Sylvia and Charles Viertel Charitable Foundation, National Heart Foundation, Western Australian Health Promotion Foundation, Freemantle Hospital
Date Deposited: 17 Jun 2016 03:11
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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