The proposed project is designed to provide an opportunity for the principal investigator (PI) to initiate and pursue an independent research career focusing on the epidemiology of chronic disease, particularly coronary heart disease. The main focus will be on the role of physical activity (PA) in primary and secondary disease prevention. The long-term follow-up and data analysis of two epidemiologic studies, a general population study and a clinical trial will provide the basis for this project. The first study will assess the long-term relationship between total PA (both during work and leisure time) and mortality in a random sample of 1656 black and white men and women residents of the City of Buffalo, New York. The study will focus on participants (30+ years of age at baseline) of the Buffalo Health Study, an epidemiological investigation conducted in Buffalo in 1960. As part of the investigation, detailed information was gathered from participants with regard to a number of demographic and socioeconomic characteristics (age, body mass index, education, marital status, etc.) and the participants' usual daily activities (both during a weekday and weekend) at work and outside work. This information will be used to compute a total PA index. The study will relate the participants' PA characteristics to their all-cause and CHD mortality experience throughout the follow-up period and test whether or not the relationship between PA and mortality is similar across gender and race. The detailed baseline demographic and socioeconomic data will allow analysis of the independence of any observed association between PA and mortality. The second study will extend to 17 years, the follow-up of the National Exercise and Heart Disease Project (NEHDP), a multi-center, randomized clinical trial designed to study the effects of a regular, medically prescribed and supervised exercise program on the rehabilitation of male survivors (ages 30-64 at baseline) of a myocardial infarction (MI). Three year findings from the trial reported non-significant differences between the treatment and control groups for all-cause mortality, and recurrent MI in favor of the exercise group. Other outcomes favoring the treatment group were reported after one year and included increased physical working capacity, and decreased body fat, diastolic blood pressure, and triglycerides. The proposed study will determine vital status for all original study participants, and cause of death in the deceased. The longer follow-up will permit analysis of whether the long-term survival of the treatment group differs from that of the controls. In addition, we will be able to assess if the risk factor changes observed in the first year of the trial were present after three years, whether these changes are related to long-term survival, whether differences in mortality observed in sub-groups (i.e. smokers) after three years remain after 17 years, and whether baseline patient characteristics (i.e., anxiety and depression) predict mortality. The collective follow- up of these two studies will provide new scientific information regarding the role of PA in the primary and secondary prevention of chronic disease, while simultaneously allowing the PI to increase her knowledge of different epidemiologic study designs and methods.
| Schunemann, H J; Dorn, J; Grant, B J et al. (2000) Pulmonary function is a long-term predictor of mortality in the general population: 29-year follow-up of the Buffalo Health Study. Chest 118:656-64 |
| Dorn, J P; Cerny, F J; Epstein, L H et al. (1999) Work and leisure time physical activity and mortality in men and women from a general population sample. Ann Epidemiol 9:366-73 |
| Dorn, J M; Schisterman, E F; Winkelstein Jr, W et al. (1997) Body mass index and mortality in a general population sample of men and women. The Buffalo Health Study. Am J Epidemiol 146:919-31 |
