| Abstract: | Introduction: C- reactive protein (CRP), an inflammatory risk marker, has been related to cardiovascular disease (CVD) and all-cause mortality, in a dose response manner. Whether the CRP-related CVD mortality risk is modifiable, particularly by physical activity, is inconclusive. Objectives: The goal of this study is to assess whether physical activity can reduce or attenuate the increased CVD mortality. Methods: A cohort of 391,390 adults was successively recruited between 1997 and 2008, and mortality was identified by linking with National Death file. Physical activity was classified based on MET-Hour/week, with 30 min/day or more of exercise as fully active, and 15 min/day of exercise as low active. CRP levels were divided into <1, 1-2.9, 3-9.9 and ≧10 mg/L, with <1 as reference. Cox models were used to calculate hazard ratios (HRs). Results: Two thirds of the cohort had CRP <1 mg/L, while 13% were above 3 mg/L, and few, 3.3%, were at >10 mg/L. Higher CRP was associated with male, older age, lower education, smoking, chewing, physically inactive, diabetic, hypertensive, obesity, high DL and HDL, high uric acid, proteinuria, and leukocytosis. Mortality risks for all cause and for CVD increased with stepwise increase of CRP. Increasing physical activity reduced the CVD mortality increase from each level of CRP, by 17% to 32%, and much of the 59%>69% increase of CVD risk for those with CRP≧ 3mg/L disappeared when becoming fully active. . Conclusion: Physical activity can lower the elevated CVD mortality risk of CRP at every level, and much of the increased CVD mortality among elevated CRP could be overcome and attenuated by physical activity. |
