Dose Response of Physical Activity in CVD and Mortality

Two recent studies highlight the importance of physical activity volume and intensity in reducing cardiovascular disease (CVD) risk and improving longevity.

The first study analyzed data from over 24,000 middle-aged and older non-exercisers in the UK Biobank, examining the effects of incidental physical activity (IPA)—unstructured daily movement outside formal exercise—on CVD and mortality. Using accelerometry, researchers categorized IPA into vigorous (VIPA), moderate (MIPA), and light (LIPA) intensities. Over nearly 8 years of follow-up, higher IPA levels, particularly VIPA and MIPA, were associated with significantly lower risks of major CVD events and death.

Key findings:

VIPA showed the strongest benefits: Just 4.6 minutes per day reduced CVD mortality risk by 38%.
Intensity mattered: 1 minute of VIPA provided CVD benefits equivalent to ~3 minutes of MIPA or 35–49 minutes of LIPA.
LIPA exhibited a modest inverse association, with statistically significant reductions in CVD mortality only at levels >130 minutes daily.

These results underscore that even brief bouts of vigorous or moderate incidental activity can substantially benefit cardiovascular health, especially for individuals unable to engage in structured exercise.

The second study, involving over 26,000 adults linked to Medicare records, explored how different physical activity (PA) levels influence coronary artery disease (CAD) and mortality. Researchers found:

Intermediate PA levels (500–2499 MET-minutes/week) were associated with the lowest heart attack risk.
High-volume exercise (≥3000 MET-minutes/week) did not further reduce CAD risk but was linked to a significantly lower all-cause mortality risk.
Coronary artery calcium (CAC), a marker of subclinical CAD, elevated CAD risk across all PA levels, including highly active individuals. This suggests that high fitness does not fully offset the risks posed by high CAC.

The takeaway: Moderate exercise may offer optimal protection against CAD, while high-volume exercise enhances longevity but does not necessarily mitigate clinical CAD risk if CAC is present.

Both studies reinforce that moderate-intensity activity on most days is highly beneficial for cardiovascular health and longevity. Intensity and consistency appear more critical than structured exercise, with even small amounts of vigorous incidental activity yielding significant benefits. Source: https://www.ahajournals.org/

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