Association of Accelerometer-Measured Physical Activity and Sedentary Behaviour with Incident Cardiovascular Disease: The Maastricht Study.

Purpose

To investigate the associations of volume and pattern of physical activity (PA) and sedentary behavior (SB) with incident cardiovascular disease (CVD), and the modifying effects of sociodemographic and health factors.

Methods

5,186 participants (mean age 59.3 years; 52.4% women) were included from The Maastricht Study. PA and SB were obtained with thigh-worn accelerometers. Annual questionnaires and government registration assessed CVD events (myocardial infarction, cerebrovascular disease, and/or peripheral vascular disease). Cox regression examined associations and effect modification by age, sex, socioeconomic position, body mass index, mobility limitation, and diabetes.

Results

654 events occurred within a 6.1-year median follow-up (IQR: 3.2-9.1 years). Individuals with >69.8 min/day moderate-to-vigorous physical activity (MVPA) [HR (95%CI): 0.68 (0.54-0.85)] and >11.9 min/day vigorous-intensity physical activity (VPA) [HR (95%CI): 0.69 (0.54-0.87)] had lower CVD risk compared with Q1 (lowest). Moderate sedentary breaks (32.0-42.6 n/day) were associated with a lower risk [Q2, HR (95%CI): 0.75 (0.61-0.92); Q3, HR (95%CI): 0.69 (0.55-0.87)] relative to Q1. Weekend warriors [MVPA ≥ 150 min/week with ≥50% in 1-2 days, HR (95%CI): 0.60 (0.44-0.82)] and regularly active individuals [HR (95%CI): 0.66 (0.50-0.88)] had lower risks relative to inactive/insufficiently active individuals. Stronger associations were observed between MVPA and CVD in women, and in limited-mobility individuals (both P-interaction < 0.05). Sedentary time, light-intensity PA, prolonged sedentary bouts, and average sedentary bout duration were not associated with CVD.

Conclusions

Higher MVPA (particularly in women and limited-mobility individuals) and VPA are associated with lower CVD risk. Overall, higher-intensity PA could be relevant for cardiovascular protection.