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Abstract
Leisure time physical activity is inversely associated with cardiovascular risk, although
evidence for the protective effects of active commuting is more limited. The present
review examines evidence from prospective epidemiological studies of commuting activity
and cardiovascular risk.
Meta-analytic procedures were performed to examine the association between commuting
physical activity and cardiovascular risk. Several cardiovascular endpoints were examined
including mortality, incident coronary heart disease, stroke, hypertension and diabetes.
We included eight studies in the overall analysis (173,146 participants) that yielded
15 separate risk ratios (RR). The overall meta-analysis demonstrated a robust protective
effect of active commuting on cardiovascular outcomes (integrated RR=0.89, 95% confidence
interval 0.81-0.98, p=0.016). However, the protective effects of active commuting
were more robust among women (0.87, 0.77-0.98, p=0.02) than in men (0.91, 0.80-1.04,
p=0.17).
Active commuting that incorporates walking and cycling was associated with an overall
11% reduction in cardiovascular risk, which was more robust among women. Future studies
should investigate the reasons for possible gender effects and also examine the importance
of commuting activity intensity.