Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study
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Authors
Fortuin-de Smidt, Melony C
Sewe, Maquins Odhiambo
Lassale, Camille
Weiderpass, Elisabete
Andersson, Jonas
Huerta, José María
Ekelund, Ulf
Aleksandrova, Krasimira
Tong, Tammy YN
Dahm, Christina C
Tjønneland, Anne
Kyrø, Cecilie
Steindorf, Karen
Schulze, Matthias B
Katzke, Verena
Sacerdote, Carlotta
Agnoli, Claudia
Masala, Giovanna
Tumino, Rosario
Panico, Salvatore
Boer, Jolanda MA
Onland-Moret, N Charlotte
Wendel-Vos, GC Wanda
van der Schouw, Yvonne T
Borch, Kristin Benjaminsen
Agudo, Antonio
Petrova, Dafina
Chirlaque, María-Dolores
Conchi, Moreno-Iribas
Amiano, Pilar
Melander, Olle
Heath, Alicia K
Aune, Dagfinn
Forouhi, Nita G
Riboli, Elio
Wareham, Nicholas J
Butterworth, Adam S
Wennberg, Patrik
Publication Date
2022-09-07Journal Title
European Journal of Preventive Cardiology
ISSN
2047-4873
Publisher
Oxford University Press (OUP)
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Fortuin-de Smidt, M. C., Sewe, M. O., Lassale, C., Weiderpass, E., Andersson, J., Huerta, J. M., Ekelund, U., et al. (2022). Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study. European Journal of Preventive Cardiology https://doi.org/10.1093/eurjpc/zwac055
Abstract
This study aimed to evaluate the association between physical activity and the incidence of coronary heart disease (CHD)
in individuals with and without CHD risk factors.
EPIC-CVD is a case-cohort study of 29 333 participants that included 13 582 incident CHD cases and a randomly selected
sub-cohort nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Self-reported
physical activity was summarized using the Cambridge physical activity index (inactive, moderately inactive, moderately
active, and active). Participants were categorized into sub-groups based on the presence or the absence of the following
risk factors: obesity (body mass index ≥30 kg/m2
), hypercholesterolaemia (total cholesterol ≥6.2 mmol/L), history of diabetes, hypertension (self-reported or ≥140/90 mmHg), and current smoking. Prentice-weighted Cox regression was used
to assess the association between physical activity and incident CHD events (non-fatal and fatal).
Compared to inactive participants without the respective CHD risk factor (referent), excess CHD risk was highest in
physically inactive and lowest in moderately active participants with CHD risk factors. Corresponding excess CHD risk
estimates amongst those with obesity were 47% [95% confidence interval (CI) 32–64%] and 21% (95%CI 2–44%), with
hypercholesterolaemia were 80% (95%CI 55–108%) and 48% (95%CI 22–81%), with hypertension were 80% (95%CI 65–
96%) and 49% (95%CI 28–74%), with diabetes were 142% (95%CI 63–260%), and 100% (95%CI 32–204%), and amongst
smokers were 152% (95%CI 122–186%) and 109% (95%CI 74–150%).
In people with CHD risk factors, moderate physical activity, equivalent to 40 mins of walking per day, attenuates but does
not completely offset CHD risk
Sponsorship
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
MRC (MC_UU_00006/1)
MRC (MC_UU_00006/3)
European Commission (602068)
MRC (MC_UU_00006/4)
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MR/N003284/1)
Identifiers
External DOI: https://doi.org/10.1093/eurjpc/zwac055
This record's URL: https://www.repository.cam.ac.uk/handle/1810/336121
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc-nd/4.0/
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