Review of interventions to prevent heart disease

doi:10.1136/bmj.315.7120.1468

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Study neglected to examine benefits of exercise

David Batty, Researchera

^a Exercise and Health Research Unit, University of Bristol, Bristol BS8 2LU
^b Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London NW3 2PF
^c Department of Social Medicine, University of Bristol, Bristol BS8 2PR

Editor—In their systematic review of interventions to reduce risk factors for coronary heart disease Shah Ebrahim and George Davey Smith examined changes in blood pressure, smoking, and blood cholesterol concentration.1 Meta-analysis supports physical inactivity as a fourth risk factor.2 3 Although the relative risk of physical inactivity (1.9) is similar to that of hypertension, smoking, and hypercholesterolaemia,4 the population attributable risk is higher owing to its greater prevalence.5 This suggests that interventions to increase physical activity may be efficacious in reducing the incidence of coronary heart disease.

Exercise was an intervention in nine of the 14 studies reviewed, yet no analysis of change …