Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study
Year: 2022
Type: article
Study design: Observational Study
Abstract: AIMS: This study aimed to evaluate the association between physical activity and the incidence of coronary heart disease (CHD) in individuals with and without CHD risk factors. METHODS AND RESULTS: EPIC-CVD is a case-cohort study of 29 333 participants that included 13 582 incident CHD cases and a randomly selected sub-cohort nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Self-reported physical activity was summarized using the Cambridge physical activity index (inactive, moderately inactive, moderately active, and active). Participants were categorized into sub-groups based on the presence or the absence of the following risk factors: obesity (body mass index ≥30 kg/m2), hypercholesterolaemia (total cholesterol ≥6.2 mmol/L), history of diabetes, hypertension (self-reported or ≥140/90 mmHg), and current smoking. Prentice-weighted Cox regression was used to assess the association between physical activity and incident CHD events (non-fatal and fatal).Compared to inactive participants without the respective CHD risk factor (referent), excess CHD risk was highest in physically inactive and lowest in moderately active participants with CHD risk factors. Corresponding excess CHD risk estimates amongst those with obesity were 47% [95% confidence interval (CI) 32-64%] and 21% (95%CI 2-44%), with hypercholesterolaemia were 80% (95%CI 55-108%) and 48% (95%CI 22-81%), with hypertension were 80% (95%CI 65-96%) and 49% (95%CI 28-74%), with diabetes were 142% (95%CI 63-260%), and 100% (95%CI 32-204%), and amongst smokers were 152% (95%CI 122-186%) and 109% (95%CI 74-150%). CONCLUSIONS: In people with CHD risk factors, moderate physical activity, equivalent to 40 mins of walking per day, attenuates but does not completely offset CHD risk.
Authors: Melony C Fortuin-de Smidt, Maquins Odhiambo Sewe, Camille Lassale, Elisabete Weiderpass, Jonas Andersson, José María Huerta, Ulf Ekelund, Krasimira Aleksandrova, Tammy YN Tong, Christina C Dahm, Anne Tjønneland, Cecilie Kyrø, Karen Steindorf, Matthias B Schulze, Verena Katzke, Carlotta Sacerdote, Claudia Agnoli, Giovanna Masala, Rosario Tumino, Salvatore Panico, Jolanda MA Boer, N Charlotte Onland-Moret, GC Wanda Wendel-Vos, Yvonne T van der Schouw, Kristin Benjaminsen Borch, Antonio Agudo, Dafina Petrova, María Dolores Chirlaque, Moreno Iribas Conchi, Pilar Amiano, Olle Melander, Alicia K Heath, Dagfinn Aune, Nita G Forouhi, Claudia Langenberg, Soren Brage, Elio Riboli, Nicholas J Wareham, John Danesh, Adam S Butterworth, Patrik Wennberg
Institutions: Umeå University, Instituto de Salud Carlos III, Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Municipal Institute for Medical Research, Hospital del Mar Research Institute, Centre international de recherche sur le cancer, Instituto Murciano de Investigación Biosanitaria, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Norwegian Institute of Public Health, Norwegian School of Sport Sciences, University of Bremen, Leibniz Institute for Prevention Research and Epidemiology - BIPS, University of Oxford, Aarhus University, University of Copenhagen, Danish Cancer Society, German Cancer Research Center, University of Potsdam, German Institute of Human Nutrition, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Fondazione IRCCS Istituto Nazionale dei Tumori, Associazione Iblea per la Ricerca Epidemiologica E.T.S., Federico II University Hospital, University of Naples Federico II, National Institute for Public Health and the Environment, Utrecht University, University Medical Center Utrecht, UiT The Arctic University of Norway, Institut d'Investigació Biomédica de Bellvitge, Institut Català d'Oncologia, Instituto de Investigación Biosanitaria de Granada, Andalusian School of Public Health, Instituto de Salud Pública de Navarra, Navarre Institute of Health Research, Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Basque Government, Biogipuzkoa Health Research Institute, Lund University, Skåne University Hospital, Imperial College London, Oslo University Hospital, Karolinska Institutet, Oslo Nye Høyskole, University of Cambridge, MRC Epidemiology Unit, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charité – Universitätsmedizin Berlin, Wellcome Sanger Institute, British Heart Foundation, National Institute for Health and Care Research, Health Data Research UK
Language: English
Topic: Physical Activity and Health
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,176
Funders: World Health Organization, Centre International de Recherche sur le Cancer, NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research, Cancer Research UK, National Institute for Health and Care Research, British Heart Foundation, Imperial College London, European Commission, Cambridge University Hospitals, Ligue Contre le Cancer, Sixth Framework Programme, University of Maryland School of Public Health, Medical Research Council, Department of Epidemiology and Biostatistics, University of California, San Francisco
Awards: Aetiology of type 2 diabetes and related metabolic disorders, Nutritional epidemiology, Large-scale integrative genomic studies of high-dimensional traits in cardiovascular diseases (renewal), G299057155, G3328679326, The EPIC-Norfolk prospective population study: biological and behavioural determinants of health and disease in an ageing population, G5271742736, G5315906942, G5897142711, NIHR Senior Investigator Award, The BHF Chair of Epidemiology and Medicine, Global initiative on gene-environment interaction on diabetes/obesity risk, Large-scale integrative studies of risk factors in coronary heart disease: from discovery to application (renewal). (Joint funding with MRC), Physical activity epidemiology, G8585681489
OpenAlex ID: W4223431899