A new study finds that brief, incidental bursts of vigorous activity significantly reduce cardiovascular event risk, especially in middle-aged women.
Cardiovascular event risk may be significantly reduced by short bursts of incidental vigorous physical exertion, according to a recent study published in the British Journal of Sports Medicine.1
Significantly reduced cardiovascular event risk has been reported in middle-aged women performing longer bouts of high intensity physical activity. However, data about the impact of shorter burst of this activity, referred to as vigorous intermittent lifestyle physical activity (VILPA), on cardiovascular outcomes remains lacking.
Cardiovascular disease is the leading cause of mortality in women, and risk factors may be influenced by sex differences in pathophysiology.2 As women have a reduced average cardiorespiratory fitness compared to men, the level of effort for long-term physical activity may be increased in this population.
To evaluate sex-specific dose-response associations of daily VILPA with major adverse cardiovascular events (MACE), investigators conducted a prospective cohort study. Participants were aged 40 to 69 years when enrolled at baseline, defined as between 2006 and 2010.
A wrist-worn accelerometer was worn for 7 days by patients between 2013 and 2015, with at least 3 valid monitoring days and 1 weekend day required for inclusion. Patients with insufficient valid wear days, missing covariate data, or an inability to walk were excluded from the analysis.
VILPA was assessed based on patients self-reporting no leisure time exercise participation and no more than 1 recreational walk per week. The analysis was repeated in patients self-reporting any participation in leisure time exercise or more than 1 recreational walk per week.
Categories of physical activity included light, moderate, and vigorous. Short bouts were those lasting up to 2 minutes, though bouts were length-standardized to 1 minute to evaluate daily VILPA frequency.
Follow-up occurred through November 30, 2022. Death information was obtained from the National Health Service (NHS) Digital of England and Wales or NHS Central Register and National Records of Scotland.
The Hospital Episode Statistics for England, the Patient Episode Database for Wales, and the Scottish Morbidity Record for Scotland provided relevant hospitalization data. Investigators defined MACE as “death or incidence of ST-elevated or non-ST elevated myocardial infarction.”
There were 22,368 participants included in the final analysis, 13,018 of whom were women and 9350 were men. These patients reported 819 MACE events, with 331 in women and 488 in men. Participants were aged a mean 61.9 years and underwent a mean 7.9 years of follow-up.
Only women presented with dose-response associations for total MACE, myocardial infarction, and heart failure. The median daily VILPA duration doses were linked to a hazard ratio (HR) of 0.55 for MACE in women vs 0.84 in men, while these were 0.33 and 0.61, respectively, for heart failure. Significant interactions were not reported for stroke.
Similar dose-respondent patterns were reported in both sex groups for length-standardized and raw daily VILPA frequency. HRs of 0.56 and 0.83 for MACE were reported in women and men, respectively, based on the median VILPA length-standardized bouts frequency. For heart failure, these HRs were 0.31 and 0.68, respectively.
For minimum daily doses, only women experienced a significant reduction of myocardial infarction, with an HR of 0.67. Similarly, women completing minimum daily doses of VILPA reported an HR of 0.60 for heart failure.
For overall MACE, a minimum frequency dose of 2.2 length-standardized bouts and 9.6 raw bouts per day was linked to an HR of 0.50 in women. In comparison, the HR in men was 0.85 for a minimum frequency dose of 1.7 length-standardized bouts and 4.4 raw bouts per day.
These results indicated improved MACE outcomes in women performing non-exercise vigorous incidental physical activity. Investigators recommended patients receive sex-specific physical activity guidelines for CVD prevention.
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