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Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis: cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study
Department of Physical Activity and Health, Swedish School of Sport and Health Sciences Gih, Stockholm, Sweden.
Center for Health and Performance, University of Gothenburg, Göteborg, Sweden; Institute of Medicine, University of Gothenburg, Göteborg, Sweden.
Department of Physical Activity and Health, Swedish School of Sport and Health Sciences Gih, Stockholm, Sweden.
Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, University of Gothenburg, Göteborg, Sweden.
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 11, article id e073380Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours.

Design: Cross-sectional.

Setting: Multisite study at university hospitals.

Participants: A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer.

Primary and secondary outcomes: Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound.

Results: High daily SED (>70% ≈10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% ≈8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% ≈20 min/day, associated with lower OR for significant CA (OR range 0.61-0.67), CACS (OR range 0.71-0.75) and CarA (OR range 0.72-0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73).

Conclusions: MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023. Vol. 13, no 11, article id e073380
Keywords [en]
cardiovascular imaging, epidemiology, public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-217547DOI: 10.1136/bmjopen-2023-073380PubMedID: 37996228Scopus ID: 2-s2.0-85177801853OAI: oai:DiVA.org:umu-217547DiVA, id: diva2:1818592
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala UniversityRegion Västra Götaland, ALFGBG- 720691Swedish Heart Lung Foundation, 20180379Available from: 2023-12-11 Created: 2023-12-11 Last updated: 2023-12-11Bibliographically approved

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Bergman, FridaSandberg, CamillaWennberg, PatrikÖhlin, Jerry

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