Wearable device-measured sedentary behaviour, physical activity, and incident symptomatic peripheral artery disease:...

To investigate associations of device-measured sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with incident symptomatic peripheral artery disease (PAD).

Cohort study.

A community-based volunteer sample recruited across the United Kingdom.

A total of N=87,490 adults without cardiovascular disease who had valid wrist-worn accelerometer data and met the study eligibility criteria.

Not applicable.

Incident symptomatic PAD identified during follow-up.

Over a median follow-up of 7.9 years, 569 participants developed symptomatic PAD. Participants in the highest SB tertile had a 43% higher risk of symptomatic PAD (hazard ratio=1.43, 95% confidence interval, 1.16-1.76) than those in the lowest tertile. In contrast, higher MVPA was associated with a lower symptomatic PAD risk, whereas LPA showed no significant association. All behaviors showed a significant nonlinear association with symptomatic PAD (all nonlinear P<.05). Joint analysis revealed the lowest symptomatic PAD risk in participants with both low SB and high MVPA, with no significant interaction. Isotemporal substitution analysis suggested that replacing SB with MVPA was associated with the greatest estimated reduction in symptomatic PAD risk.

Higher SB is independently associated with a higher symptomatic PAD risk, whereas greater MVPA is associated with a lower risk. These findings underscore the potential importance of considering both MVPA promotion and sedentary time reduction in future PAD prevention.