CLINICAL
NEWS
American College of Cardiology Extended Learning
Running for Your Life
Even at ‘low doses,’ running offers substantial mortality benefits
I
t is the Second Running Boom and still going strong
as it enters its third decade. Overall, according to
the latest available data from Running USA, there
were 19,025,000 finishers in U.S. running events in
2013 (a record).1 Females represented the highest
percentage ever reported (57%) but both males and
females set new record high participation rates.
Those numbers, however, pale compared to leisure runners. While you might think of jogging as
an activity consistently popular with a proportion
of the populace, the number of self-reported joggers/runners in the U.S. has increased from 45.67
million in the spring of 2008 to 65.48 million in
the spring of 2014, a 43.4% increase.
Clearly, running is a popular leisure-time physical
activity, but what do we know about the long-term
effects of running on mortality? Similarly, is there
a dose-response relationship between running and
mortality?
RUNNING AND MORTALITY
The Aerobics Center Longitudinal Study is a prospective, observational cohort study designed to examine the effects of physical activity and fitness on
various health outcomes. Conducted by the Cooper
Clinic in Dallas, TX, investigators recently reported
the association of running with all-cause and CV
mortality risk in 55,137 adults, 18 to 100 years of
age (mean age 44 years), 24% of whom participated
in regular running/jogging.2
During a mean follow-up of 15 years, 3,413 allcause and 1,217 CV deaths occurred. Compared with
nonrunners, runners had 30% and 45% lower risks
of all-cause and CVD mortality, respectively, after adjusting for potential confounders. These associations
were consistent regardless of sex, age, BMI, health
conditions, smoking status, and alcohol consumption.
Dr. Lavie and colleagues noted that not running
was almost as negative an influence as other prognostic variables such as smoking, obesity, or hypertension (TABLE). Also, nonrunners had a lower life
expectancy of 3 years compared with runners after
adjusting for other mortality predictors.
Investigators analyzed intensity of running/jogging activity by assessing quintiles of running time,
distance, frequency, amount, and speed compared
with nonrunners. Even participation at the low end
of these ranges—weekly running < 51 minutes, < 6
miles, 1 to 2 times, < 506 metabolic equivalent-minutes, or < 6 miles/hour—was sufficient to reduce
risk of mortality, compared with not running.
However, mortality benefits were similar
between lower and higher doses of weekly running time. In fact, among runners (after nonrunners were excluded in the analyses), there were no
significant differences in HRs of all-cause and CVD
mortality across quintiles of weekly running time
(all p values > 0.10).
ACC.org/CSWN
RUNNING,
MORE OR
LESS
TABLE
Effect of Running Compared to Other Common Mortality Predictors
All–Cause Mortality
Cardiovascular Mortality
Recently, the
PAF
Decreased Life
Decreased Life
Copenhagen
Mortality Predictor
HR
(%)
Expectancy (y)rs
HR
PAF (%) Expectancy (y)rs
City Heart
Nonrunner
1.24
16
3.0
1.40
25
4.1
Study found
Current smoker
1.67
11
7.0
1.69
12
6.3
similar
Overweight or obesity
1.16
8
2.0
1.43
20
4.4
mortality
Parental CVD
1.20
7
2.5
1.38
13
3.9
benefits in
1.55
7
6.0
2.43
17
10.7
1,878 joggers Abnormal ECG
compared
Hypertension
1.46
15
5.2
1.94
28
8.0
with nonjogDiabetes
1.36
3
4.2
1.53
6
5.1
gers,3 after
Hyperc