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Prospective Study of Physical Activity and Risk of Asthma Exacerbations in Older Women

¹ Center for Research in Environmental Epidemiology, ² Municipal Institute of Medical Research-Hospital del Mar, ³ Department of Experimental and Health Sciences, Universitat Pompeu Fabra, and ⁴ Centro de Investigación Biomédica en Red de Epidemiologia y Salud Pública, Barcelona, Spain; ⁵ Institut National de la Santé et de la Recherche Médicale, U780-IFR69, and ⁶ University Paris-Sud, Villejuif, France; and ⁷ Department of Emergency Medicine, Massachusetts General Hospital, and ⁸ Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts

Correspondence and requests for reprints should be addressed to Judith Garcia-Aymerich, M.D., Center for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain. E-mail: jgarcia{at}creal.cat

Rationale: The potential role of physical activity in preventing asthma exacerbations is unknown.

Objectives: To investigate the longitudinal association between regular physical activity and asthma exacerbations.

Methods: A total of 2,818 women with asthma from a large U.S. cohort (the Nurses' Health Study) were monitored from 1998 to 2000. Physical activity was self-reported at baseline, using a validated questionnaire, and categorized in quintiles. Exacerbations during follow-up were defined as a self-report of asthma-related hospitalization, emergency department visit, or urgent office visit. Baseline information about severity of asthma, treatment, previous exacerbations, sociodemographic factors, smoking, and other potential confounders was obtained.

Measurements and Main Results: Participants had a mean age of 63 years, and 71% had mild-to-moderate persistent asthma. About half of the women were ever-smokers (48% former, 6% current), and median physical activity was 10 MET·hours/week (equivalent to walking at a brisk pace for 20 minutes three times per week). Risk of exacerbations during follow-up decreased with increasing level of physical activity. In a multivariate logistic regression model, the higher level of physical activity, the lower risk of admission (odds ratio 0.85, 0.81, 0.78, and 0.76, for the 2nd, 3rd, 4th, and 5th quintiles compared with the 1st quintile, P for trend = 0.05). There were no relevant differences on stratifying by age group, smoking status, body mass index, baseline use of inhaled corticosteroids, or previous exacerbations.

Conclusions: Regular physical activity was associated with reduced risk of exacerbations in women with asthma in this longitudinal study.

Key Words: motor activity • exercise • asthma • epidemiology

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject The potential role of physical activity in preventing asthma exacerbations is unknown. What This Study Adds to the Field This prospective study of older women shows that a higher level of regular physical activity is associated with a lower risk of an asthma exacerbation, independent of asthma severity and other covariates. The results support the recommendation of regular physical activity to most individuals with asthma.