Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment
Background: Physical activity (PA) influences sympathetic stimulation, platelet activation as well as vascular function, and has been associated with improved health outcomes in patients with coronary heart disease. β-blocker therapy reduces sympathetic activity and improves platelet and endothelial...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
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| Series: | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772487522000265 |
| _version_ | 1798001524244217856 |
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| author | Indu Dhar Gard FT. Svingen Eva KR. Pedersen Arve Ulvik Espen Ø. Bjørnestad Simon N. Dankel Gunnar Mellgren Ottar K. Nygård |
| author_facet | Indu Dhar Gard FT. Svingen Eva KR. Pedersen Arve Ulvik Espen Ø. Bjørnestad Simon N. Dankel Gunnar Mellgren Ottar K. Nygård |
| author_sort | Indu Dhar |
| collection | DOAJ |
| description | Background: Physical activity (PA) influences sympathetic stimulation, platelet activation as well as vascular function, and has been associated with improved health outcomes in patients with coronary heart disease. β-blocker therapy reduces sympathetic activity and improves platelet and endothelial function. We investigated if β-blocker treatment modifies the association of self-reported PA with the risk of all-cause mortality. Methods: A total of 2284 patients undergoing elective coronary angiography for suspected stable angina pectoris (SAP) were studied. Using Cox modeling, we examined associations between PA (categorized as ‘sedentary/inactive’, ‘low’, ‘moderate’, and ‘high’) and all-cause mortality according to β-blocker therapy. Results: During a median follow-up of 10.3 years, 390 patients (17.1%) died. Higher PA was generally associated with a more favorable cardiovascular risk profile. Compared to the patients who were sedentary or inactive, the age and sex adjusted HRs (95% CI) for all-cause mortality were 0.89 (0.66–1.20), 0.73 (0.57–0.95) and 0.72 (0.55–0.95) in the low, moderate and high PA group, respectively. However, and notably, these risk estimates were 0.85 (0.60–1.20), 0.65 (0.47–0.89) and 0.58 (0.41–0.81) in β-blocker treated subjects vs. 1.00 (0.57–1.78), 0.96 (0.61–1.52) and 1.20 (0.74–1.95) in non-treated groups (Pinteraction = 0.018). The results were essentially similar in the multivariable adjusted models. Conclusions: In patients with suspected SAP, increased PA was associated with reduced mortality risk primarily in patients treated with β-blockers. |
| first_indexed | 2024-04-11T11:37:36Z |
| format | Article |
| id | doaj.art-233403895f264ac2a0d0473e376733be |
| institution | Directory Open Access Journal |
| issn | 2772-4875 |
| language | English |
| last_indexed | 2024-04-11T11:37:36Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| spelling | doaj.art-233403895f264ac2a0d0473e376733be2022-12-22T04:25:55ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752022-12-0115200150Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatmentIndu Dhar0Gard FT. Svingen1Eva KR. Pedersen2Arve Ulvik3Espen Ø. Bjørnestad4Simon N. Dankel5Gunnar Mellgren6Ottar K. Nygård7Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway; Corresponding author. Department of Clinical Science, University of Bergen, Laboratory Building, 9th floor, Haukeland University Hospital, Jonas Lies vei 87, Bergen N‐5021, Norway.Department of Heart Disease, Haukeland University Hospital, Bergen, NorwayDepartment of Heart Disease, Haukeland University Hospital, Bergen, NorwayBevital AS, Bergen, NorwayDepartment of Cardiology, Stavanger University Hospital, Stavanger, NorwayMohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway; Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, NorwayMohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway; Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, NorwayMohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Heart Disease, Haukeland University Hospital, Bergen, NorwayBackground: Physical activity (PA) influences sympathetic stimulation, platelet activation as well as vascular function, and has been associated with improved health outcomes in patients with coronary heart disease. β-blocker therapy reduces sympathetic activity and improves platelet and endothelial function. We investigated if β-blocker treatment modifies the association of self-reported PA with the risk of all-cause mortality. Methods: A total of 2284 patients undergoing elective coronary angiography for suspected stable angina pectoris (SAP) were studied. Using Cox modeling, we examined associations between PA (categorized as ‘sedentary/inactive’, ‘low’, ‘moderate’, and ‘high’) and all-cause mortality according to β-blocker therapy. Results: During a median follow-up of 10.3 years, 390 patients (17.1%) died. Higher PA was generally associated with a more favorable cardiovascular risk profile. Compared to the patients who were sedentary or inactive, the age and sex adjusted HRs (95% CI) for all-cause mortality were 0.89 (0.66–1.20), 0.73 (0.57–0.95) and 0.72 (0.55–0.95) in the low, moderate and high PA group, respectively. However, and notably, these risk estimates were 0.85 (0.60–1.20), 0.65 (0.47–0.89) and 0.58 (0.41–0.81) in β-blocker treated subjects vs. 1.00 (0.57–1.78), 0.96 (0.61–1.52) and 1.20 (0.74–1.95) in non-treated groups (Pinteraction = 0.018). The results were essentially similar in the multivariable adjusted models. Conclusions: In patients with suspected SAP, increased PA was associated with reduced mortality risk primarily in patients treated with β-blockers.http://www.sciencedirect.com/science/article/pii/S2772487522000265Physical activityβ-blocker therapyStable angina pectorisMortality |
| spellingShingle | Indu Dhar Gard FT. Svingen Eva KR. Pedersen Arve Ulvik Espen Ø. Bjørnestad Simon N. Dankel Gunnar Mellgren Ottar K. Nygård Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment International Journal of Cardiology. Cardiovascular Risk and Prevention Physical activity β-blocker therapy Stable angina pectoris Mortality |
| title | Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment |
| title_full | Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment |
| title_fullStr | Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment |
| title_full_unstemmed | Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment |
| title_short | Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment |
| title_sort | physical activity and risk of all cause mortality in patients with stable angina pectoris effect modification by β blocker treatment |
| topic | Physical activity β-blocker therapy Stable angina pectoris Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2772487522000265 |
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