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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

Ekblom-Bak, Elin ; Börjesson, Mats ; Ekblom, Örjan ; Angerås, Oskar ; Bergman, Frida ; Berntsson, Caroline ; Carlhäll, Carl-Johan ; Engström, Gunnar LU ; Engvall, Jan and Fagman, Erika , et al. (2023) In BMJ Open 13(11).
Abstract

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... (More)

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.

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Contribution to journal
publication status
published
subject
keywords
Male, Middle Aged, Humans, Female, Cross-Sectional Studies, Exercise, Coronary Artery Disease/diagnostic imaging, Carotid Artery Diseases/diagnostic imaging, Atherosclerosis, Accelerometry/methods
in
BMJ Open
volume
13
issue
11
article number
e073380
publisher
BMJ Publishing Group
external identifiers
  • scopus:85177801853
  • pmid:37996228
ISSN
2044-6055
DOI
10.1136/bmjopen-2023-073380
language
English
LU publication?
yes
id
9657857d-99bc-4d92-869c-4a192455bfc7
date added to LUP
2023-12-01 09:15:47
date last changed
2025-03-20 08:05:57
@article{9657857d-99bc-4d92-869c-4a192455bfc7,
  abstract     = {{<p>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.</p><p>DESIGN: Cross-sectional.</p><p>SETTING: Multisite study at university hospitals.</p><p>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.</p><p>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.</p><p>RESULTS: High daily SED (&gt;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 (&gt;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, &gt;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).</p><p>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.</p>}},
  author       = {{Ekblom-Bak, Elin and Börjesson, Mats and Ekblom, Örjan and Angerås, Oskar and Bergman, Frida and Berntsson, Caroline and Carlhäll, Carl-Johan and Engström, Gunnar and Engvall, Jan and Fagman, Erika and Flinck, Agneta and Johansson, Peter and Jujic, Amra and Kero, Tanja and Lind, Lars and Mannila, Maria and Ostenfeld, Ellen and Persson, Anders and Persson, Jonas and Persson, Margaretha and Redfors, Björn and Sandberg, Camilla and Wennberg, Patrik and Öhlin, Jerry and Östgren, Carl Johan and Jernberg, Tomas}},
  issn         = {{2044-6055}},
  keywords     = {{Male; Middle Aged; Humans; Female; Cross-Sectional Studies; Exercise; Coronary Artery Disease/diagnostic imaging; Carotid Artery Diseases/diagnostic imaging; Atherosclerosis; Accelerometry/methods}},
  language     = {{eng}},
  month        = {{11}},
  number       = {{11}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2023-073380}},
  doi          = {{10.1136/bmjopen-2023-073380}},
  volume       = {{13}},
  year         = {{2023}},
}