Association of accelerometer-derived physical activity with all-cause and cause-specific mortality among individuals with cardiovascular diseases: A prospective cohort study.

ABSTRACT

AIMS: To investigate the association of accelerometer-measured intensity-specific physical activity (PA) with all-cause and cause-specific mortality among individuals with cardiovascular disease (CVD). METHODS: In this prospective cohort study, 8,024 individuals with pre-existing CVD (mean age 66.6 years, female 34.1%) from the UK Biobank had their PA measured using wrist-worn accelerometers over a 7-day period in 2013-2015. All-cause, cancer, and CVD mortality was ascertained from death registries. Cox regression modelling and restricted cubic splines were used to assess the associations. Population-attributable fractions (PAFs) were used to estimate the proportion of preventable deaths if more PA were undertaken. RESULTS: During an average of 6.8 years of follow-up, 691 deaths (273 from cancer and 219 from CVD) were recorded. An inverse non-linear association was found between PA duration and all-cause mortality risk, irrespective of PA intensity. The hazard ratio (HR) of all-cause mortality plateaued at 1800 minutes/week for light-intensity PA (LPA), 320 minutes/week for moderate-intensity PA (MPA) and 15 minutes/week for vigorous-intensity PA (VPA). The highest quartile of PA associated lower risks for all-cause mortality, with HRs of 0.63 (95% confidence interval [CI] 0.51-0.79), 0.42 (0.33-0.54) and 0.47 (0.37-0.60) for LPA, MPA, and VPA, respectively. Similar associations were observed for cancer and CVD mortality. Additionally, the highest PAF were noted for VPA, followed by MPA. CONCLUSION: We found an inverse non-linear association between all intensities of PA (LPA, MPA, VPA, and MVPA) and mortality risk in CVD patients using accelerometer-derived data, but with larger magnitude of the associations than that in previous studies based on self-reported PA.

This study investigated the associations of accelerometer-derived intensity-specific physical activity (PA) with the risks of all-cause and cause-specific mortality among individuals with cardiovascular disease (CVD). L-shaped dose-response relationships between the duration of PA and all-cause mortality were observed across all levels of PA intensities. The risk reduction for mortality exhibited a sharp decline from 0 to 1800 minutes/week of light-intensity PA, followed by reaching a plateau. Notably, the inflection points for moderate-intensity PA and vigorous-intensity PA were found at 320 and 15 minutes per week, respectively. The population-attributable fraction analysis indicated that a significant number of deaths could potentially be prevented if individuals with CVD engaged in more vigorous physical activities.