Thorax 61:772-778 doi:10.1136/thx.2006.060145
  • Chronic obstructive pulmonary disease

Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study

  1. J Garcia-Aymerich1,
  2. P Lange2,3,
  3. M Benet1,
  4. P Schnohr2,
  5. J M Antó1,4
  1. 1Respiratory and Environmental Health Research Unit, Institut Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
  2. 2Copenhagen City Heart Study, Epidemiological Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark
  3. 3Department of Cardiology and Respiratory Diseases, Hvidovre University Hospital, Denmark
  4. 4Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
  1. Correspondence to:
    Dr J Garcia-Aymerich
    Respiratory and Environmental Health Research Unit, Institut Municipal d’Investigació Mèdica (IMIM), Doctor Aiguader 80, E-08003-Barcelona, Spain; jgarcia{at}
  • Received 7 February 2006
  • Accepted 10 May 2006
  • Published Online First 31 May 2006


Background: Information about the influence of regular physical activity on the course of chronic obstructive pulmonary disease (COPD) is scarce. A study was undertaken to examine the association between regular physical activity and both hospital admissions for COPD and all-cause and specific mortality in COPD subjects.

Methods: From a population-based sample recruited in Copenhagen in 1981–3 and 1991–4, 2386 individuals with COPD (according to lung function tests) were identified and followed until 2000. Self-reported regular physical activity at baseline was classified into four categories (very low, low, moderate, and high). Dates and causes of hospital admissions and mortality were obtained from Danish registers. Adjusted associations between physical activity and hospital admissions for COPD and mortality were obtained using negative binomial and Cox regression models, respectively.

Results: After adjustment for relevant confounders, subjects reporting low, moderate or high physical activity had a lower risk of hospital admission for COPD during the follow up period than those who reported very low physical activity (incidence rate ratio 0.72, 95% confidence interval (CI) 0.53 to 0.97). Low, moderate and high levels of regular physical activity were associated with an adjusted lower risk of all-cause mortality (hazard ratio (HR) 0.76, 95% CI 0.65 to 0.90) and respiratory mortality (HR 0.70, 95% CI 0.48 to 1.02). No effect modification was found for sex, age group, COPD severity, or a background of ischaemic heart disease.

Conclusions: Subjects with COPD who perform some level of regular physical activity have a lower risk of both COPD admissions and mortality. The recommendation that COPD patients be encouraged to maintain or increase their levels of regular physical activity should be considered in future COPD guidelines, since it is likely to result in a relevant public health benefit.


  • Published Online First 31 May 2006

  • Funding: Supported in part by grants from the Generalitat de Catalunya-DURSI 2001/SGR/00406. JG-A and MB were respectively funded by the Red RESPIRA Network (RTIC C03/11) and the Red RCESP Network (RTIC C03/09), from the Instituto de Salud Carlos III. The Copenhagen City Heart Study was supported by grants from The Danish Heart Foundation, The Danish Lung Association and Danish Medical Research Council. No part of the research presented has been funded by tobacco industry sources. The sources of funding had no involvement in study design and conduct; collection, management, analysis or interpretation of data; and preparation, review, or approval of the manuscript.

  • Competing interests: none.

  • JG-A, PL, PS, and JMA participated in the design of the study; PL and PS coordinated data collection in Copenhagen; JG-A, PL, MB, and JMA performed the statistical analysis and interpreted the results; JG-A prepared the first draft of the paper; and all the authors contributed to the writing of paper. JG-A had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.