Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study
Background Despite the well‐established capacity of physical activity to reduce blood pressure, the associations between physical activity with cardiovascular disease (CVD) incidence and mortality in people living with hypertension are not well understood. We examine the dose‐response associations o...
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| Format: | Article |
| Language: | English |
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Wiley
2022-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.023290 |
| _version_ | 1797859038852022272 |
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| author | Borja del Pozo Cruz Matthew Ahmadi Elif Inan‐Eroglu Bo‐Huei Huang Emmanuel Stamatakis |
| author_facet | Borja del Pozo Cruz Matthew Ahmadi Elif Inan‐Eroglu Bo‐Huei Huang Emmanuel Stamatakis |
| author_sort | Borja del Pozo Cruz |
| collection | DOAJ |
| description | Background Despite the well‐established capacity of physical activity to reduce blood pressure, the associations between physical activity with cardiovascular disease (CVD) incidence and mortality in people living with hypertension are not well understood. We examine the dose‐response associations of device‐assessed physical activity with all‐cause and CVD mortality and CVD incidence (total, stroke, and coronary heart disease) in adults with hypertension. Methods and Results This prospective study included data from 39 294 participants with hypertension in the UK Biobank study who had valid accelerometry data and for whom mortality and CVD followed‐up data were available. We categorized moderate‐to‐vigorous physical activity and total physical activity volume into 4 categories based on the 10th, 50th, and 90th percentiles and used Cox regressions to estimate their associations with CVD mortality and incidence outcomes. Splines were used to assess the dose‐response associations. During a median follow‐up of 6.25 years (241 418 person‐years), 1518 deaths (549 attributable to CVD) and 4933 CVD (fatal and nonfatal) incident events were registered. Compared with the lowest category of moderate‐to‐vigorous physical activity, the relative risks (hazard ratios and 95% CIs) of all‐cause mortality for increasing categories were 0.53 (0.46–0.61), 0.41 (0.34–0.49), and 0.36 (0.26–0.49). We found associations of similar magnitude for total CVD incidence, stroke, and coronary heart disease; and for total physical activity volume across all outcomes. For all outcomes, there were linear or nearly linear inverse dose‐response relationships with no evidence of harms with high levels of physical activity. Results were robust to removing participants who died within the first 2 years. Conclusions Our findings underscore the importance of physical activity for people living with hypertension and provide novel insights to support the development of physical activity guideline recommendations for this high‐risk group. |
| first_indexed | 2024-04-09T21:23:01Z |
| format | Article |
| id | doaj.art-b882e36e00bd42ed8374e3285ea1d7aa |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T21:23:01Z |
| publishDate | 2022-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b882e36e00bd42ed8374e3285ea1d7aa2023-03-28T04:20:50ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-03-0111610.1161/JAHA.121.023290Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank StudyBorja del Pozo Cruz0Matthew Ahmadi1Elif Inan‐Eroglu2Bo‐Huei Huang3Emmanuel Stamatakis4Department of Sports Science and Clinical Biomechanics Centre for Active and Healthy Ageing University of Southern Denmark Odense DenmarkCharles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales AustraliaCharles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales AustraliaCharles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales AustraliaCharles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales AustraliaBackground Despite the well‐established capacity of physical activity to reduce blood pressure, the associations between physical activity with cardiovascular disease (CVD) incidence and mortality in people living with hypertension are not well understood. We examine the dose‐response associations of device‐assessed physical activity with all‐cause and CVD mortality and CVD incidence (total, stroke, and coronary heart disease) in adults with hypertension. Methods and Results This prospective study included data from 39 294 participants with hypertension in the UK Biobank study who had valid accelerometry data and for whom mortality and CVD followed‐up data were available. We categorized moderate‐to‐vigorous physical activity and total physical activity volume into 4 categories based on the 10th, 50th, and 90th percentiles and used Cox regressions to estimate their associations with CVD mortality and incidence outcomes. Splines were used to assess the dose‐response associations. During a median follow‐up of 6.25 years (241 418 person‐years), 1518 deaths (549 attributable to CVD) and 4933 CVD (fatal and nonfatal) incident events were registered. Compared with the lowest category of moderate‐to‐vigorous physical activity, the relative risks (hazard ratios and 95% CIs) of all‐cause mortality for increasing categories were 0.53 (0.46–0.61), 0.41 (0.34–0.49), and 0.36 (0.26–0.49). We found associations of similar magnitude for total CVD incidence, stroke, and coronary heart disease; and for total physical activity volume across all outcomes. For all outcomes, there were linear or nearly linear inverse dose‐response relationships with no evidence of harms with high levels of physical activity. Results were robust to removing participants who died within the first 2 years. Conclusions Our findings underscore the importance of physical activity for people living with hypertension and provide novel insights to support the development of physical activity guideline recommendations for this high‐risk group.https://www.ahajournals.org/doi/10.1161/JAHA.121.023290activityagingexercisehigh blood pressureprimary preventionsecondary prevention |
| spellingShingle | Borja del Pozo Cruz Matthew Ahmadi Elif Inan‐Eroglu Bo‐Huei Huang Emmanuel Stamatakis Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease activity aging exercise high blood pressure primary prevention secondary prevention |
| title | Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study |
| title_full | Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study |
| title_fullStr | Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study |
| title_full_unstemmed | Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study |
| title_short | Prospective Associations of Accelerometer‐Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study |
| title_sort | prospective associations of accelerometer assessed physical activity with mortality and incidence of cardiovascular disease among adults with hypertension the uk biobank study |
| topic | activity aging exercise high blood pressure primary prevention secondary prevention |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.023290 |
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