Ability of physical activity to predict cardiovascular disease beyond commonly evaluated cardiometabolic risk factors

It is well-established that increasing physical activity (PA) is important for the prevention and management of cardiovascular disease (CVD). Although it has been demonstrated that PA predicts CVD independent of commonly measured cardiometabolic risk factors in women, it is unclear whether this association is true in men. The study participants consisted of 5,882 adults (age >or=18 years) from the 1999 to 2004 United States National Health and Nutrition Examination Survey. Blood pressure, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glucose, and waist circumference were categorized using standard clinical thresholds. The participants were divided into the following groups according to the volume of their moderate-to-vigorous intensity PA: active (>or=150 min/wk), somewhat active (30 to 149 min/wk), and inactive (<30 min/wk). Logistic regression analyses were used to calculate the odds ratios for CVD according to PA. After controlling for the basic confounders (age, gender, race, smoking), inactive participants were 52% (95% confidence interval 16% to 98%) more likely than the active participants to have CVD. Additional adjustment for cardiometabolic risk factors did not change the odds ratio for CVD in the inactive group. To further delineate the effects of PA on CVD, the participants were cross-classified according to their PA level and their number of cardiometabolic risk factors. Both PA and cardiometabolic risk factors were independent predictors of CVD (P(trend) <0.0001). The results were not modified by gender. In conclusion, PA was associated with CVD, independent of the common cardiometabolic risk factors, in men and women. The association between PA and CVD risk was not mediated by the measured cardiometabolic risk factors.