Lewis phenotypes, leisure time physical activity, and risk of ischaemic heart disease: an 11 year follow up in the Copenhagen male study. Issue 2 (1st February 2001)

• Record Type: Journal Article
• Authors: Hein, H O; Suadicani, P; Gyntelberg, F
• Is Part Of: Heart. Volume 85:Issue 2(2001)
• Page Start: 159
• Page End: 164
• Publication Date: 2001-02-01
• Subjects: genetics -- ischaemic heart disease -- risk factors; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heart.85.2.159
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : OBJECTIVE: To test the hypothesis that the predictive value for risk of fatal ischaemic heart disease associated with Lewis phenotypes depends on the level of leisure time physical activity. DESIGN: Prospective study controlling for alcohol, tobacco, serum cotinine, blood pressure, body mass index, serum lipids, work related physical activity, and social class. SETTING: The Copenhagen male study, Denmark. SUBJECTS: 2826 white men aged 53–75 years without overt cardiovascular disease; 266 (9.4%) had the Le(a−b−) phenotype. MAIN OUTCOME MEASURE: Incidence of death from ischaemic heart disease during 11 years. RESULTS: 107 men died of ischaemic heart disease. Among men with a low level of leisure time physical activity (⩽ 4 hours/week moderate or ⩽ 2 hours/week more vigorous activity), being Le(a−b−) was associated with an increased risk of having a fatal ischaemic heart disease event compared with men with other Lewis phenotypes (relative risk (RR) 2.7, 95% confidence interval (CI) 1.4 to 5.2; p < 0.01). Among men with a high level of leisure time physical activity, the RR associated with being Le(a−b−) was 1.3 (95% CI 0.5 to 3.1; NS). Compared with all other alternatives tested, being Le(a−b−) and having a low level of leisure time physical activity was associated with an RR of 3.2 (95% CI 1.7 to 5.8; p < 0.001). As a point estimate and adjusted for confounding variables, among men with low leisure time physical activity the attributable risk associated with Le(a−b−) was 12%—that is, assuming that all sedentary men had phenotypes other than Le(a−b−), 12% of all fatal ischaemic heart disease events would not have occurred. The corresponding point estimate among those more active was 2%. CONCLUSIONS: The excess risk of fatal ischaemic heart disease in middle aged and elderly men with the Le(a−b−) phenotype is strongly modified by leisure time physical activity. Public health and clinical implications may be important in populations with a predominantly sedentary lifestyle and in a high proportion of men with the Le(a−b−) phenotype.