Natural selection to sports, later physical activity habits, and coronary heart disease

Objectives-To investigate the associations between natural selection to sports at a young age, continuity of physical activity, and occurrence of coronary heart disease. Design-Prospective cohort study. Setting-Finland. Participants-Former top level male athletes participating at a young age (1920-1965) in different types of sport (endurance (n = 166), power speed (n = 235), "other" (n = 834)) and controls healthy at the age of 20 years (n = 743). Main outcome measures-Data on the occurrence of coronary heart disease were obtained from death certificates, three nationwide registers, and questionnaire studies in 1985 and 1995, and data on later physical activity were obtained from the questionnaires. Results-In 1985 all groups of former athletes were more physically active than controls (p<0.001). Despite similar total volumes of physical activity, compared with power speed athletes, former endurance athletes participated more often in vigorous activity (p = 0.006) and had less coronary heart disease (adjusted odds ratio 0.34, 95% confidence interval 0.17 to 0.73; p = 0.004). In 1985 and 1995, both endurance and other athletes had less coronary heart disease than controls. From 1986 to 1995, the incidence of new coronary heart disease was lower among those who participated in vigorous physical activity in 1985. Conclusions-Both a previous aptitude for endurance athletic events and continuity of vigorous physical activity seem to be associated with protection against coronary heart disease, but an aptitude for power speed events does not give protection against coronary heart disease.