Does Vigorous Physical Activity Further Reduce Risk for Cardiovascular Disease?
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
Population-based, longitudinal cohort study (UK Biobank)
Adults aged 40 to 69 years
Without prior or concurrent CVD
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
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
Participants in the lowest category of total PA
Had higher body mass index and C-reactive protein
Were diagnosed with hypertension
Linear Dose-Response Relationship Between PA and Risk Of CVD
Hazard ratio (HR) 3rd to 4th (lowest) quarter of distribution: 0.71 (95% CI, 0.65 to 0.77)
HR 2nd to 4th HR 0.59 (95% CI, 0.54 to 0.65)
HR 1st to 4th: HR 0.46 (95% CI, 0.41 to 0.51)
HR 3rd to 4th: HR 0.70 (95% CI, 0.64 to 0.77)
HR 2nd to 4th: HR 0.54 (95% CI, 0.49 to 0.59)
HR 1st to 4th: HR 0.41 (95% CI, 0.37 to 0.46)
Total volume of PA
HR 3rd to 4th: HR 0.73 (95% CI, 0.67 to 0.79)
HR 2nd to 4th: HR 0.63 (95% CI, 0.57 to 0.69)
HR 1st to 4th: HR 0.47 (95% CI, 0.43 to 0.52)
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”
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