Family History-Guided Physical Activity for Cardiovascular Disease Prevention

It remains unclear whether individuals with a family history of cardiovascular disease can achieve similar cardiovascular disease incidence reductions through moderate-to-vigorous physical activity as those without a family history. The aim of this study was to investigate the importance of a familial cardiovascular disease history on the association of moderate-to-vigorous physical activity with cardiovascular disease risk.

A prospective cohort from the United Kingdom Biobank that completed 1 week of accelerometer-based moderate-to-vigorous physical activity measurements from June 1, 2013, to December 23, 2015, was analyzed. The exposures were the various doses of moderate-to-vigorous physical activity derived from accelerometry. The main outcomes and measures were the dose-response associations between moderate-to-vigorous physical activity and incident cardiovascular disease in individuals with and without a family history of cardiovascular disease.

A total of 74,715 individuals (mean age, 55.2 years) were examined. The median follow-up time was 7.9 years. The dose-response association between moderate-to-vigorous physical activity and incident cardiovascular disease among individuals with a family history of cardiovascular disease showed significant risk reductions within the range of 10-1,555 weekly minutes (reference: 0 minutes of moderate-to-vigorous physical activity). The optimal risk reduction (i.e., the nadir of the curve) was identified at 555 weekly minutes of moderate-to-vigorous physical activity (hazard ratio, 0.72 [95% CI=0.64, 0.81]). The dose-response associations between moderate-to-vigorous physical activity and incident cardiovascular disease among individuals with no family history of cardiovascular disease showed significant risk reductions within the range of 220-555 weekly minutes. The optimal risk reduction was identified at 445 weekly minutes of moderate-to-vigorous physical activity (hazard ratio, 0.80 [95% CI=0.65, 0.99]).

Physical activity guidelines should account for familial cardiovascular disease history because those with a family history may achieve greater risk reductions.