Physical activity is not only associated with a lower risk of cardiovascular disease, but there is no threshold for that association, with the lowest risk of cardiovascular disease seen for those who are more active, according to a new study published this week in PLOS Medicine by Terence Dwyer of the University of Oxford, UK, and colleagues.
Research has shown that there is an inverse association between self-reported physical activity and the occurrence of cardiovascular diseases. However, there is uncertainty about the scope of this association, especially at the highest levels of physical activity. In the new study, the researchers used data from 90,211 UK Biobank participants without previous cardiovascular disease who agreed to use an accelerometer to measure their physical activity over a 7-day period from 2013 to 2015.
Participants in the lowest physical activity category smoked more, had higher body mass index and C-reactive protein and were more frequently diagnosed with hypertension. Overall, there were 3,617 cases of cardiovascular disease diagnosed in participants during an average of 5.2 years of follow-up. People in each increasing quartile of physical activity, for moderate intensity activity, vigorous intensity activity and total physical activity, were less likely to have cardiovascular disease. For example, compared to those in the lower quartile, those in the second quartile of moderate-intensity exercise were 71% likely to be diagnosed with cardiovascular disease (95% CI 0.65-0.77), those in the third quartile were 59 % as likely (95% CI 0.54-0.65) and those in the highest quartile were 46% more likely (95% CI 0.41-0.51). Although potential confounding factors have been taken into account, the possibility of unknown confounding factors or reverse causality cannot be completely ruled out in the current study.
Associate professor Aiden Doherty, of the University of Oxford’s Nuffield Department of Population Health and a leading author of the study, said: “This is the largest study ever done on physical activity and cardiovascular disease measured by fancy devices. It shows this activity physical activity is probably even more important for the prevention of cardiovascular disease than we previously thought. Our results reinforce the new WHO guidelines on physical activity, which recommend at least 150 to 300 minutes of moderate to vigorous aerobic activity per week for all adults ” .
Professor Terry Dwyer, of the University of Oxford’s Nuffield Department of Women’s and Reproductive Health and lead author of the study, said: “The results of this study increase confidence that physical activity is likely to be an important way to prevent cardiovascular disease. The estimated risk reduction potential in people who practice relatively high levels of activity is substantial and justifies a greater emphasis on measures to increase levels of physical activity in the community. “
Dr Rema Ramakrishnan, from the University of Oxford’s Department of Women’s and Reproductive Health and the first author of this study, said: “We are confident about the results of the study because physical activity was objectively assessed by a more valid tool that can capture the frequency, intensity, and duration of physical activity, rather than self-reported by participants. We were also fortunate to have access to data from the UK Biobank study, a rich source of data that could answer that question.
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