Fig. 4

Cardiovascular incidence risk associated with high vs. low LTPA among (a) low OPA (b) moderate OPA and (c) high OPA. Each bar represents a study/analysis. The height of each bar indicates the study quality; with higher bars assessed as higher quality with fewer biases. Bars are arranged by publication date moving from oldest to newest. * – Not based on formal statistical testing, but visual trends of data. ¥ – Trend of increasing risk for coronary heart disease and decreasing for cardiovascular disease. † − Findings are for both coronary heart disease and cardiovascular disease events. ‡ − Includes moderate and active OPA group (greater % active vs. moderate among men, and ~ equal distribution among women). ǂ – Findings are for men without ischemic heart disease