The ability of physical activity in reducing mortality risks and cardiovascular loading and in extending life expectancy in patients with COPD

Chin-Chung Shu,Min-Kuang Tsai,Ta-Chen Su,June-Han Lee,Chi Pang Wen

doi:10.1038/s41598-021-00728-2

Chin-Chung Shu, Min-Kuang Tsai + Show 3 more

Open Access

https://doi.org/10.1038/s41598-021-00728-2

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Abstract

For chronic obstructive pulmonary disease (COPD), the role of physical activity in reducing COPD mortality and heart loading and in extending life expectancy remains unclear. Participants in comprehensive medical screening were recruited with spirometry on everyone. We analyzed physical activity volume calculated from intensity, duration and frequency of self-reported exercise history. Deaths were identified from the National Death File. The impacts of physical activity on mortality, heart rate and life expectancy were analyzed. Among the cohort of 483,603 adults, 32,535 had spirometry-determined COPD, indicating an adjusted national prevalence of 11.4% (male) and 9.8% (female). On the average, COPD increased all-cause mortality with a hazard ratio of 1.44 and loss of 6.0 years in life expectancy. Almost two thirds (65%) of the causes of deaths were extra-pulmonary, such as cardiovascular disease, diabetes, cancer and kidney diseases. In addition, COPD was associated with increases in heart rate proportionate to its severity, which led to higher mortality. Participants with COPD who were fully active physically could reduce mortality and have improved heart rates as compared with those without physical activity. In addition, their life expectancy could be extended close to those of the no COPD but inactive cohort. Fully active physical activity can help patients with COPD overcome most of the mortality risks, decrease heart rate, and achieve a life expectancy close to that of patients without COPD. The effectiveness of physical activity on COPD is facilitated by its systemic nature beyond lung disease.

Highlights

Chronic obstructive pulmonary disease (COPD) remains a common disease and accounts for a global disease burden of more than 300 million worldwide[1,2]
With the availability of a large cohort of nearly half a million subjects from a health surveillance program and with exercise volume calculated for each individual[17], we studied the systemic effect of leisure time physical activity on patients with COPD
The ability of regular physical activity to reduce the harm of COPD has been demonstrated in this study with the number of years gained in life expectancy

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) remains a common disease and accounts for a global disease burden of more than 300 million worldwide[1,2]. Treating COPD with medication has not been satisfactory, as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stated that “there is a lack of high quality evidence to support initial pharmacological treatment” (2020 GOLD)[9]. Other effective strategies to reduce mortality or to improve the outcome of COPD are rarely reported, and regular leisure time physical activity (exercise) as a non-pharmacological treatment emerged as an essential management to explore because patients with COPD have low levels of physical a ctivity[10,11], which is correlated with m ortality[12]. With the availability of a large cohort of nearly half a million subjects from a health surveillance program and with exercise volume calculated for each individual[17], we studied the systemic effect of leisure time physical activity on patients with COPD

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Conclusion