Associations of Objectively Measured Physical Activity and Sedentary Time with the Risk of Stroke, Myocardial Infarction
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ORIGINAL RESEARCH ARTICLE
Associations of Objectively Measured Physical Activity and Sedentary Time with the Risk of Stroke, Myocardial Infarction or All‑Cause Mortality in 70‑Year‑Old Men and Women: A Prospective Cohort Study Marcel Ballin1,2 · Peter Nordström1 · Johan Niklasson1 · Anna Nordström2,3
© The Author(s) 2020
Abstract Objective To study the associations of objectively measured physical activity (PA) and sedentary time (ST) with the combined outcome of incident stroke, myocardial infarction (MI) or all-cause mortality in older adults. Methods N = 3343 men and women aged 70 who participated in a health survey between 2012 and 2017 were included. Actigraph GT3X+ accelerometers were used to measure light-intensity PA (LPA), moderate-intensity PA (MPA) and ST for 1 week. Incident cases of cardiovascular disease (CVD) in terms of stroke or MI, and all-cause mortality were identified using national registers. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable-adjusted Cox regressions. Results During a mean follow-up of 2.7 years (0.1–5.6), there were 124 events of CVD or all-cause mortality. After adjusting for potential confounders and mediators, every 30-min/day increment in LPA was associated with 11% lower risk of CVD or all-cause mortality (HR 0.89, 95% CI 0.82–0.97), and every 30-min/day increment in MPA was associated with 36% lower risk (HR 0.64, 95% CI 0.48–0.84). Every 1-h/day increment in ST increased the risk of the outcomes by 33% (HR 1.33, 95% CI 1.14–1.56), although there was no significant association among participants who performed ≥ 30 min/day MPA (HR 1.11, 95% CI 0.82–1.50, P = 0.034 for interaction). None of the associations were modified by sex (P > 0.4 for all). Conclusion Objectively measured LPA and MPA are each associated with lower risk of stroke, MI or all-cause mortality in 70-year-old individuals, while ST is associated with increased risk. The greatest risk reduction is observed for MPA, which also appears to attenuate some of the increased risks associated with ST.
* Peter Nordström [email protected] 1
Department of Community Medicine and Rehabilitation, Unit of Geriatric Medicine, Umeå University, 901 87 Umeå, Sweden
2
Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
3
School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
Vol.:(0123456789)
M. Ballin et al.
Key Points In this study of more than 3300 70-year-old men and women, we found that both light- and moderate-intensity physical activity were each linked to lower risk of stroke, myocardial infarction or all-cause mortality. Moderateintensity physical activity entailed the greatest relative risk reduction, around threefold that of light-intensity physical activity. Sedentary behavior was linked to an increased risk of stroke, myocardial infarction or all-cause mortality. However, we also found that some of the increased risks pertaining to sedentary behavior may potent
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