Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Background The inverse association between physical activity and cardiovascular disease (CVD) is well‐ established and has previously been shown in people with and without single CVD risk factors. We examined whether level of global cardiovascular risk, on the basis of the pooled cohort equation or...

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Main Authors: Andrea K. Chomistek, Nancy R. Cook, Eric B. Rimm, Paul M. Ridker, Julie E. Buring, I.‐Min Lee
Format: Article
Language:English
Published: Wiley 2018-06-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.117.008234
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author Andrea K. Chomistek
Nancy R. Cook
Eric B. Rimm
Paul M. Ridker
Julie E. Buring
I.‐Min Lee
author_facet Andrea K. Chomistek
Nancy R. Cook
Eric B. Rimm
Paul M. Ridker
Julie E. Buring
I.‐Min Lee
author_sort Andrea K. Chomistek
collection DOAJ
description Background The inverse association between physical activity and cardiovascular disease (CVD) is well‐ established and has previously been shown in people with and without single CVD risk factors. We examined whether level of global cardiovascular risk, on the basis of the pooled cohort equation or Reynolds risk score, which include multiple risk factors, modified the physical activity–CVD association. Methods and Results Participants in the prospective WHS (Women's Health Study; n=27 536) reported their leisure‐time physical activity at study entry (1992–1995) and during follow‐up through 2013. Participants were divided into 10‐year cardiovascular risk groups on the basis of the pooled cohort equation and Reynolds risk score. The primary outcome was incident total CVD. The CVD hazard ratio for active (≥500 kcal/wk of physical activity) compared with inactive (<500 kcal/wk) individuals was 0.73 (95% confidence interval, 0.66–0.80) in multivariable models. This association was not modified by level of cardiovascular risk; physical activity was inversely associated with CVD within all pooled cohort equation and Reynolds risk score groups (P=0.17 and P=0.66 for interaction, respectively). When the joint association of physical activity and level of cardiovascular risk was examined, women with higher risk on the basis of either the pooled cohort equation or Reynolds risk score had higher CVD rates compared with those at low risk, regardless of physical activity. However, among women at both high and low risk, being physically active was associated with lower risk of CVD events. Conclusions In this large prospective cohort of women, level of global cardiovascular risk did not modify the inverse association between leisure‐time physical activity and incident CVD. Thus, promoting physical activity is important in women at both low and high cardiovascular risk.
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spelling doaj.art-1bf12076197144d995977ae4fd94a58a2022-12-22T02:41:17ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-06-0171210.1161/JAHA.117.008234Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?Andrea K. Chomistek0Nancy R. Cook1Eric B. Rimm2Paul M. Ridker3Julie E. Buring4I.‐Min Lee5Department of Epidemiology and Biostatistics School of Public Health Indiana University Bloomington INDivision of Preventive Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MAChanning Division of Network Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MADivision of Preventive Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MADivision of Preventive Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MADivision of Preventive Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MABackground The inverse association between physical activity and cardiovascular disease (CVD) is well‐ established and has previously been shown in people with and without single CVD risk factors. We examined whether level of global cardiovascular risk, on the basis of the pooled cohort equation or Reynolds risk score, which include multiple risk factors, modified the physical activity–CVD association. Methods and Results Participants in the prospective WHS (Women's Health Study; n=27 536) reported their leisure‐time physical activity at study entry (1992–1995) and during follow‐up through 2013. Participants were divided into 10‐year cardiovascular risk groups on the basis of the pooled cohort equation and Reynolds risk score. The primary outcome was incident total CVD. The CVD hazard ratio for active (≥500 kcal/wk of physical activity) compared with inactive (<500 kcal/wk) individuals was 0.73 (95% confidence interval, 0.66–0.80) in multivariable models. This association was not modified by level of cardiovascular risk; physical activity was inversely associated with CVD within all pooled cohort equation and Reynolds risk score groups (P=0.17 and P=0.66 for interaction, respectively). When the joint association of physical activity and level of cardiovascular risk was examined, women with higher risk on the basis of either the pooled cohort equation or Reynolds risk score had higher CVD rates compared with those at low risk, regardless of physical activity. However, among women at both high and low risk, being physically active was associated with lower risk of CVD events. Conclusions In this large prospective cohort of women, level of global cardiovascular risk did not modify the inverse association between leisure‐time physical activity and incident CVD. Thus, promoting physical activity is important in women at both low and high cardiovascular risk.https://www.ahajournals.org/doi/10.1161/JAHA.117.008234coronary heart diseaseexerciseprimary preventionrisk assessmentstroke
spellingShingle Andrea K. Chomistek
Nancy R. Cook
Eric B. Rimm
Paul M. Ridker
Julie E. Buring
I.‐Min Lee
Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
coronary heart disease
exercise
primary prevention
risk assessment
stroke
title Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?
title_full Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?
title_fullStr Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?
title_full_unstemmed Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?
title_short Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?
title_sort physical activity and incident cardiovascular disease in women is the relation modified by level of global cardiovascular risk
topic coronary heart disease
exercise
primary prevention
risk assessment
stroke
url https://www.ahajournals.org/doi/10.1161/JAHA.117.008234
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