BACKGROUND AND PURPOSE:

• Physical activity is associated with a decreased risk of cardiovascular disease (CVD), but whether vigorous physical activity is associated with a further decreased risk of CVD is not well known
• Ramakrishnan et al. (PLos Medicine, 2021) used UK Biobank data to examine the association between accelerometer-measured moderate, vigorous, and total physical activity and incident CVD

METHODS:

• Population-based, longitudinal cohort study (UK Biobank)
• Participants
  • Adults aged 40 to 69 years
  • Without prior or concurrent CVD
• Study design
  • Participants wore an accelerometer on their dominant wrist for 7 days
  • Total volume of physical activity (PA) was measured using average vector magnitude in milli-gravity (mg) units, a metric that has been validated against the gold-standard measure for energy expenditure
  • Definitions
    • Moderate physical activity: Percentage time spent at 100 to 400 milli-gravity units
    • Vigorous physical activity: Percentage time spent >400 milli-gravity units
  • Adjustments were made for confounding (such as age, smoking, sex, ethnicity, alcohol use, area-based social deprivation)
  • Incident CVD was defined as the first hospital admission or death from CVD

RESULTS:

• 90,211 participants
• Participants in the lowest category of total PA
  • Smoked more
  • Had higher body mass index and C-reactive protein
  • Were diagnosed with hypertension

Linear Dose-Response Relationship Between PA and Risk Of CVD

• Moderate PA
  • Hazard ratio (HR) 3^rd to 4^th (lowest) quarter of distribution: 0.71 (95% CI, 0.65 to 0.77)
  • HR 2^nd to 4^th HR 0.59 (95% CI, 0.54 to 0.65)
  • HR 1^st to 4^th: HR 0.46 (95% CI, 0.41 to 0.51)
• Vigorous PA
  • HR 3^rd to 4^th: HR 0.70 (95% CI, 0.64 to 0.77)
  • HR 2^nd to 4^th: HR 0.54 (95% CI, 0.49 to 0.59)
  • HR 1^st to 4^th: HR 0.41 (95% CI, 0.37 to 0.46)
• Total volume of PA
  • HR 3^rd to 4^th: HR 0.73 (95% CI, 0.67 to 0.79)
  • HR 2^nd to 4^th: HR 0.63 (95% CI, 0.57 to 0.69)
  • HR 1^st to 4^th: HR 0.47 (95% CI, 0.43 to 0.52)

CONCLUSION:

• More vigorous physical activity appears to be associated with a greater reduction in CVD risk, without an upper limit threshold
• The authors conclude that

The finding of no threshold effect aligns with the recommendations of the UK Chief Medical Officer’s report on PA that “some physical activity is good but more is better”

Learn More – Primary Sources:

Accelerometer measured physical activity and the incidence of cardiovascular disease: Evidence from the UK Biobank cohort study

Related ObG Topics:

The Physical Activity Guidelines for Americans – HHS Recommendations

More From the PURE Study: Does Type of Exercise Matter When it Comes to Decreasing Mortality and CVD?  

Is Physical Activity Associated with Lower Risk of Fractures in Older Women?

The Relationship between Exercise and Heart Disease – Does Genetics Matter?