Physical activity, alcohol and tobacco use and associated cardiovascular morbidity and mortality in the Second Australian National Blood Pressure study cohort

SIR—Globally, ~17 million people die each year of cardiovascular disease (CVD) [1]. The incidence of CVD increases with age. Hypertension is an important modifiable risk factor for CVD and is the most significant risk factor for stroke [2–6]. Hypertension prevalence increases with age such that most people aged 60 years or more have it [4, 5]. The presence of other cardiovascular risk factors increases the risk of CVD from hypertension [2]. All hypertensive aged individuals therefore require attention to their behavioural risk factors for hypertension and CVD. Physical inactivity and smoking are modifiable risk factors for CVD [7, 8]. High alcohol consumption and a sedentary lifestyle contribute to the risk of hypertension in the elderly and thus mortality from its associated disease outcomes [9– 12]. We sought to ascertain the prevalence rate at baseline and the changes over time of alcohol intake, cigarette smoking and physical activity among 6,083 Australian hypertensive elderly who participated in the Second Australian National Blood Pressure study* [13]. The risk of cardiovascular events or death from any cause as a result of these lifestyle factors was also assessed.