P5137The impact of exercise volume on all-cause mortality, cardiovascular mortality and sudden cardiac arrest: a nationwide cohort study

Abstract

Background: Regular exercise and physical activity had been proven to have various cardiovascular benefits and to be associated with reduced mortality. Purpose: We aimed to investigate the relationships between the volume of exercise and mortality in real-world general population. Methods: Among 506,805 individuals (253,825 men and 252,980 women) of sample cohort in Korean National Health Insurance Service between 2003 through 2013, we searched the individuals with all-cause death, cardiovascular (CV) death and sudden cardiac arrest (SCA). Based on the questionnaires regarding general health status in medical screening program, the intensity, duration and volume of exercise were evaluated. Results: During 46.2±15.1 months of follow-up, 6,432 all-cause death, 1,204 CV death and 634 SCA occurred in the sample cohort. Compared with individuals without exercise, those who exercised more than 30 minutes a week were associated with decreased age and sex-adjusted risk of all-cause death (HR 0.622, 95% CI 0.592-0.654), CV death (HR 0.553, 95% CI 0.492-0.620, p<0.001) and SCA (HR 0.644, 95% CI 0.548-0.757, p<0.001). Multivariate Cox-regression analysis revealed that all-cause death and CV mortality consistently reduced in all groups classified by intensity and duration of exercise. However, the magnitude of this relationship between high-volume exercise (>30 MET.h/wk) and SCA reduction was attenuated. Subgroup analysis revealed that the middle-aged individuals showed no statistically significant risk reduction of SCA with exercise. Exercise seems to be most beneficial to old-age female group (HR 0.468, 95% CI 0.362-0.604, p<0.001). Conclusion: Regular exercise is associated with decreased all-cause death, CV death and SCA, especially in old-aged and female gender group, whereas in high volume exercise group and middle-age group, no significant association was seen between exercise and SCA events. (Figure Presented).