Recent observations in this prospective study of some 57,500 Harvard and University of Pennsylvania alumni(ae) have shown that the habits of increasing levels of physical activity, taking up moderately vigorous sports play, quitting cigarette smoking, remaining normotensive, and avoiding obesity, independently reduced the risk of developing coronary heart disease (CHD) and promoted survival. The proposed continuation of study will have two major aims: 1) to refine and extend observations on continuity and change in physical activity for relation to cardiovascular disease (CVD) morbidity and mortality, to functional capacity and quality of life, and to longevity; and 2) to direct special emphasis to the type, intensity, duration, and timing of exercise that distinguish the effects of light, moderate, and vigorous activities on health. In accomplishing these aims, confounding, interaction, and trends of relations with personal characteristics and other health habits will be taken into account. Resources for study include: 1) college student data of 1916-1950 collected from health, social, and athletic records; 2) contemporary alumni(ae) data collected on eight occasions, 1962-1993, by mail questionnaires pertaining to physician-diagnosed disease, physical exercise, cigarette smoking, body size and shape, diet, alcohol consumption, other life way elements, and family disease patterns; and 3) annual cause-specific mortality certification, 1916-1998. Anticipated deaths (1989-1998) from CHD will approximate 5,500; from stroke, 1,000; and from all causes, 14,500. Non-fatal CHD and stroke events will increase these already large numbers substantially. Using both prior and redefined definitions of physical activity, the investigators will direct attention to continued and altered exercise patterns, both increases and decreases in energy expenditure, between the 1960s and 70s, between the 70s and 80s, and between the 80s and 90s for relation through 1998 to incidence of non-fatal and fatal CVD, and to quality-adjusted years of life remaining. Statistical power to detect relations between exercise and CVD will be considerable for alumni, although weak for alumnae. Thus, the investigators state that projected observations should show whether and how a shift in specific ways-of-living by men in mid-life influence CVD incidence and survival. They also state that observations should clarify the relative importance of light, moderate, and vigorous physical activities (total vs. gradations of exercise intensity) in protecting against CVD and in increasing longevity.
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