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Regular Physical Activity Modifies Smoking-related Lung Function Decline and Reduces Risk of Chronic Obstructive Pulmonary Disease

A Population-based Cohort Study

¹ Centre for Research in Environmental Epidemiology (CREAL), Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain; ² Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark; ³ Department of Cardiology and Respiratory Diseases, Hvidovre University Hospital, Denmark; and ⁴ Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain

Correspondence and requests for reprints should be addressed to Dr. Judith Garcia-Aymerich, Centre for Research in Environmental Epidemiology (CREAL), Institut Municipal d'Investigació Mèdica (IMIM), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain. E-mail: jgarcia{at}imim.es

Rationale: We have previously reported that regular physical activity reduces risk of chronic obstructive pulmonary disease (COPD) exacerbation. We hypothesized that higher levels of regular physical activity could reduce the risk of COPD by modifying smoking-related lung function decline.

Objective: To estimate the longitudinal association between regular physical activity and FEV₁ and FVC decline and COPD risk.

Methods: A population-based sample (n = 6,790) was recruited and assessed with respect to physical activity, smoking, lung function, and other covariates, in Copenhagen in 1981–1983, and followed until 1991–1994. Mean level of physical activity between baseline and follow-up was classified into "low," "moderate," and "high." FEV₁ and FVC decline rates were expressed as milliliters per year. COPD was defined as FEV₁/FVC 70%. Adjusted associations between physical activity and FEV₁ and FVC decline, and COPD incidence, were obtained using linear and logistic regression, respectively.

Results: Active smokers with moderate and high physical activity had a reduced FEV₁ and FVC decline compared with those with low physical activity (relative change of +2.6 and +4.8 ml/yr of FEV₁, P-for-trend = 0.006, and +2.6 and +7.7 ml/yr of FVC, P-for-trend < 0.0001, for the moderate and high physical activity group, respectively), after adjusting for all potential confounders and risk factors of lung function decline. Active smokers with moderate to high physical activity had a reduced risk of developing COPD as compared with the low physical activity group (odds ratio, 0.77; p = 0.027).

Conclusions: This prospective study shows that moderate to high levels of regular physical activity are associated with reduced lung function decline and COPD risk among smokers.

Key Words: motor activity • exercise • pulmonary disease, chronic obstructive • respiratory function tests • epidemiology

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject There are no known modifiable factors—apart from smoking—that may reduce lung function decline. The role of physical activity on COPD development is not known. What This Study Adds to the Field Regular physical activity may reduce lung function decline and risk of developing COPD among active smokers.

 

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