Refined physical activity recommendations considering cardiovascular disease risk stratification: a cohort study

Area of Science:

• Cardiovascular disease prevention
• Exercise physiology
• Public health

Background:

• Current physical activity (PA) recommendations are often generalized.
• Optimal PA patterns for diverse cardiovascular disease (CVD) risk groups are not well-defined.
• Personalized PA strategies are needed to refine public health guidelines.

Purpose of the Study:

• To identify optimized PA patterns for different CVD risk populations.
• To refine existing PA recommendations based on individual risk.
• To investigate the association between PA and incident CVD across risk strata.

Main Methods:

• Prospective cohort study of 72,884 UK Biobank participants.
• Accelerometer-derived PA metrics (TPA, MPA, VPA, MVPA, sedentary time) analyzed.
• CVD risk stratification using SCORE2, SCORE2-Older Persons, and SCORE2-Diabetes models.
• Cox regressions and compositional data analysis used to model PA-CVD associations.

Main Results:

• Inverse association between total PA (TPA) and moderate-to-vigorous PA (MVPA) with incident CVD.
• Very high-risk populations showed the greatest benefit from increased MVPA (20% hazard reduction per 150 min/week).
• Optimal vigorous PA (VPA) thresholds identified: <60 min/week for high-risk, <42 min/week for very high-risk individuals.

Conclusions:

• PA recommendations should be personalized based on individual CVD risk.
• Tailoring VPA is crucial for high- and very high-risk groups to maximize benefits.
• Integrating risk assessment into PA guidelines enhances cardioprotective effects and safety.