Being Fit Reduces Risk of Heart Disease

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Wessel TR, Arant CB, Olson MB, et al.: Relationship of physical fitness vs. body mass index with coronary artery disease and cardiovascular events in women. JAMA 292:1179-1187, 2004.

What is the problem and what is known about it so far?

Obesity is linked to a higher risk of coronary heart disease (CHD). Most studies of obesity don't do a good job of linking physical activity and fitness. And many studies of physical fitness have not studied women.

Researchers wanted to look at what physical fitness and obesity have to do with women's risk of heart disease.

Who was studied?

A total of 936 women in the Women's Ischemia Syndrome Evaluation (WISE) study, conducted by the National Heart, Lung, and Blood Institute, were chosen for this study. From 1996 to 2000, women were enrolled at four U.S. medical centers. All the women had been examined for chest pain or suspected heart disease.

How was the study done?

At the start of the study, researchers collected information about each woman, including symptoms, overall health, and results from lab tests. The researchers figured each woman's body mass index (BMI). BMI is a measure of weight in relation to height. The women filled out questionnaires, and researchers used their answers to estimate how active the women were.

The women were followed for an average of four years. Researchers kept track of heart disease, heart attack, hospitalization, stroke, heart failure, and other things.

What did the researchers find?

During the four years, 337 women, or 36%, had a health event. Overweight women were more likely to have heart disease. Women who were less fit were more likely to have one of these health problems.

Women who were more fit had fewer heart disease risk factors or other health problems.

What were the limitations of the study?

Women filled out the questionnaires themselves, so their answers may not have been completely correct. Also, it isn't clear if not being physically active leads to heart disease, or if heart disease causes people not to be active. Researchers did not use the best ways to figure out body fat, and they did not collect information on the women's eating habits.

What are the implications of the study?

Fitness may be more important for a woman's risk of heart disease than overweight or obesity. Doctors should recommend that women with heart disease be more active.