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Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study

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Title: Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study
Authors: Fortuin-de Smidt, MC
Sewe, MO
Lassale, C
Weiderpass, E
Andersson, J
Huerta, JM
Ekelund, U
Aleksandrova, K
Tong, TYN
Dahm, CC
Tjønneland, A
Kyrø, C
Steindorf, K
Schulze, MB
Katzke, V
Sacerdote, C
Agnoli, C
Masala, G
Tumino, R
Panico, S
Boer, JMA
Onland-Moret, NC
Wendel-Vos, GCW
Van der Schouw, YT
Borch, KB
Agudo, A
Petrova, D
Chirlaque, M-D
Conchi, M-I
Amiano, P
Melander, O
Heath, AK
Aune, D
Forouhi, NG
Langenberg, C
Brage, S
Riboli, E
Wareham, NJ
Danesh, J
Butterworth, AS
Wennberg, P
Item Type: Journal Article
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.
Issue Date: Sep-2022
Date of Acceptance: 10-Mar-2022
URI: http://hdl.handle.net/10044/1/96481
DOI: 10.1093/eurjpc/zwac055
ISSN: 2047-4873
Publisher: Oxford University Press (OUP)
Start Page: 1618
End Page: 1629
Journal / Book Title: European Journal of Preventive Cardiology
Volume: 29
Issue: 12
Copyright Statement: © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Coronary heart disease
Case-cohort study
Physical activity
Population preventable fraction
Risk factors
Case-cohort study
Coronary heart disease
Physical activity
Population preventable fraction
Risk factors
Cohort Studies
Coronary Disease
Prospective Studies
Risk Factors
Coronary Disease
Risk Factors
Cohort Studies
Prospective Studies
Publication Status: Published
Open Access location: https://doi.org/10.1093/eurjpc/zwac055
Online Publication Date: 2022-04-11
Appears in Collections:Faculty of Medicine
School of Public Health

This item is licensed under a Creative Commons License Creative Commons