Background Although the benefit of physical activity on cardiovascular health has been well demonstrated, being physically active can be difficult for healthcare workers. Active commuting such as walking or cycling may be a good way to promote physical activity. Aims To investigate the relationship between active commuting and cardiovascular disease (CVD) risk factors in healthcare workers. Methods A cross-sectional study of healthcare workers conducted in Chiang Mai University Hospital, Thailand. Information on demographics and lifestyle, including active commuting, was obtained from questionnaires. Results were analysed with multiple logistic regression, adjusting for other physical activity and possible confounders. Results Among 3204 participants fewer than half engaged in active commuting. After adjustment for possible confounders, low active commuting was associated with increased risk of hypertension (adjusted OR (aOR) 1.3, 95% CI: 1.1-1.7). High active commuting was associated with central obesity (aOR 1.4, 95% CI: 1.0-1.8). Compared to non-active commuters, younger active commuters (aged under 40) had reduced prevalence of hypertension (aOR 0.4, 95% CI: 0.2-1.0), while older active commuters (aged 40 or over) demonstrated increased hypertension (aOR 1.6, 95% CI: 1.1-2.3) and central obesity (aOR 1.5, 95% CI: 1.1-2.1). Conclusions We found conflicting evidence on the relationship between active commuting and cardiovascular risk factors. Reverse causation may explain the association between active commuting and hypertension and central obesity and should be investigated further. </p
