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How Is Demanding Physical Activity Related To Cardiovascular Disease? According to the World Health Organization (WHO), physical inactivity has been identified as the 4th leading risk factor for mortality causing an estimated 3.2 million deaths globally. Regular moderate intensity physical activity, like walking and cycling, can help lower the risk of heart disease, diabetes, colon and breast cancer, depression, and stroke. Does this mean that people should increase the amount of their physical activity significantly? Probably not! In fact, jobs involving hard manual labor might pose danger to, rather than help the heart. Physically demanding work has harmful effect on an individual’s risk of coronary heart disease. This was what scientists had cautioned the public at the EuroPRevent 2013 that was organized by the European Association for Cardiovascular Prevention and Rehabilitation (EACPR) and was held in Rome from April 18 - 23, 2013. In the first study, researchers from Harokopio University, Athens evaluated occupation in 250 consecutive patients with a first stroke, 250 with a first acute coronary heart disease and 500 equally matched controls. They reported that people suffering the stroke and coronary heart disease were more commonly engaged in physically demanding occupation.
Their results, after adjusting for various risk factors like age, sex, body mass index, smoking, hypertension, hypercholesterolemia, diabetes, family history of cardiovascular disease and adherence to the Mediterranean diet, showed that those occupied in progressively less physically demanding jobs were at a 20 percent lower risk of acute coronary events or of ischemic stroke. The findings were also published online April 29, 2013 in the ‘American Journal of Cardiology’. The other study, reported by researchers in Belgium and Denmark, also suggested that physically demanding work is a risk factor for coronary heart disease, even when leisure-time activity was taken into account. The paper appeared in the March 2013 issue of ‘European Journal of Epidemiology’ and provided more details about how occupational and leisure activity might interact. A group of 14,337 middle-aged men without heart disease were involved in the study. They answered standardized questions regarding their jobs, heart health and any physical activity they did for leisure between 1994 and 1998. Classical coronary risk factors were measured through clinical examinations and questionnaires. During a mean follow-up period of 3.15 years, the researchers monitored the incidence of coronary heart events and used statistical modeling to assess how physical activity was related to coronary heart disease. Adjustments were made for age, education, occupational class, job strain, body mass index, smoking, alcohol consumption, diabetes, blood pressure, and cholesterol. Analysis showed an overall beneficial effect of leisure time physical activity but an adverse effect of demanding physical work. There was an interaction effect shown in the results: while moderate-to-high physical activity during leisure time was linked to a 60 percent reduction in the risk of coronary events in men with low occupational physical activity, such protective effect was not found in those workers who were also exposed to high physical work demands. In addition, men with high physical works were more than 4 times likely to have coronary heart disease when they also engaged in physical activity during leisure time, after adjusting for socio-demographic and well established coronary risk factors. Should people with physically demanding jobs also engage in leisure time activity? According to researchers, additional physical activity during leisure time for these people does not induce a training effect but rather an overloading effect on their cardiovascular system. However, only few studies have specifically addressed this interaction between both types of physical activity with some conflicting findings reported. Hence, more research using detailed and objective measures of activity is needed. Clearly, people who engage with physically demanding manual jobs should be considered a primary target group for prevention of cardiovascular disease. Stress could be one reason why hard physical work might not be comparable to the physical exercise recommended for health that tends to be of non-stressful behaviors. Moreover, people who have physically demanding work often not well paid. This might also restrict their access to the healthcare system.
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