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Leisure-time physical activity, daily sitting time, and risk of mortality among CVD patients: a prospective cohort
Changnan Xu1, Kai Jin2, Yike Sun3
1Physical Education Department, Nanjing University of Aeronautics and Astronautics, Nanjing, China.
Insights
Engaging in sufficient leisure-time physical activity (LTPA) and minimizing daily sitting time (DST) significantly lowers mortality risk in cardiovascular disease (CVD) patients. This highlights the importance of both exercise and reduced sedentary behavior for improved health outcomes.
Area of Science:
- Cardiovascular Health
- Public Health
- Epidemiology
Background:
- Cardiovascular disease (CVD) is a primary global cause of death.
- Leisure-time physical activity (LTPA) and daily sitting time (DST) influence health, but their combined effects on mortality in CVD patients need more research.
Purpose of the Study:
- To investigate the independent and combined associations of LTPA and DST with mortality risk in a US adult population with CVD.
Main Methods:
- A prospective cohort study analyzed 2,335 US adults with CVD from NHANES (2007-2018).
- LTPA was categorized (inactive, insufficient, sufficient), and DST was grouped (0-<6, 6-<8, ≥8 hours/day).
- Mortality data were tracked via the National Death Index, with Cox proportional hazards models used for analysis.
Main Results:
- Sufficient LTPA (≥150 min/week) was linked to significantly reduced all-cause, CVD, and non-CVD mortality.
- Each 60 min/week increase in LTPA correlated with lower mortality risks.
- High DST (≥8 hours/day) was associated with increased risks for all-cause, CVD, and non-CVD mortality.
- The lowest mortality risk was observed in individuals with sufficient LTPA and DST <6 hours/day.
Conclusions:
- Increasing LTPA and decreasing DST may offer significant benefits for reducing mortality in individuals with CVD.
- Lifestyle modifications focusing on physical activity and sedentary behavior are crucial for managing CVD patient outcomes.
Background:
Cardiovascular disease (CVD) is a leading cause of mortality globally. While leisure time physical activity (LTPA) and daily sitting time (DST) are known modulators of health, their combined impact on mortality risk specifically among CVD patients warrants further investigation. This study aimed to examine the independent and joint associations of LTPA and DST with mortality in a nationally representative sample of US adults with CVD.
Methods:
This prospective cohort study included 2,335 adults with CVD (weighted mean age 61.56 years; 57.12% male) from the National Health and Nutrition Examination Survey (NHANES) 2007-2018, followed for a median of 5.75 years. LTPA was categorized as inactive (0 min/week), insufficiently active (1-<150 min/week), and sufficiently active (≥150 min/week). DST was categorized as 0-<6, 6-<8, and ≥8 h/days. Mortality data were obtained through linkage to the National Death Index until December 31, 2019. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for covariates.
Results:
Over 14,139 person-years, 552 deaths (197 CVD-related) occurred. Sufficient LTPA (≥150 min/week) was associated with reduced risks of all-cause (HR: 0.45, 95% CI: 0.31-0.66, P < 0.001), CVD (HR: 0.51, 95% CI: 0.25-1.02, P = 0.058), and non-CVD mortality (HR: 0.43, 95% CI: 0.28-0.65, P < 0.001). Per 60 min/week increase in weekly LTPA was associated with 10% (HR: 0.90, 95% CI: 0.85-0.95) lower risk of all-cause mortality, 12% (HR: 0.88, 95% CI: 0.79-0.97) lower risk of CVD mortality, and 9% (HR: 0.91, 95% CI: 0.84-0.98) lower risk of non-CVD mortality, respectively. DST ≥8 h/days increased risks of all-cause (HR: 1.89, 95% CI: 1.50-2.37, P < 0.001), CVD (HR: 2.22, 95% CI: 1.51-3.26, P < 0.001), and non- CVD mortality (HR: 1.75, 95% CI: 1.29-2.36, P < 0.001) compared to <6 h/days. Combined analyses showed the lowest mortality risk in sufficiently active individuals with DST <6 h/days (all-cause HR: 0.27, 95% CI: 0.18-0.41, P < 0.001).
Conclusion:
This study suggests that increasing leisure-time physical activity and reducing sedentary time may have potential benefits for reducing mortality in patients with CVD.
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