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Risk for CV events, mortality varies by physical activity type

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April 16, 2021

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Disclosures:
The study and editorial authors report no relevant financial disclosures.


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Higher self-reported leisure-time physical activity was associated with reduced major adverse CV event and all-cause mortality risk, but higher occupational physical activity was linked to increased risks, researchers reported.

“The novel demonstration of the independent association of the two types of physical activity on risk of major adverse CV events and all-cause mortality supports the physical activity paradox,” Andreas Holtermann, PhD, of the National Research Centre for the Working Environment in Copenhagen, Denmark, and colleagues wrote.



Higher self-reported leisure-time physical activity was associated with reduced major adverse CV event and all-cause mortality risk, but higher occupational physical activity was linked to increased risks. Data were derived from Holtermann A, et al. Eur Heart J. 2021;doi:10.1093/eurheartj/ehab087.

Researchers analyzed 104,046 participants from the Copenhagen General Population Study. During a mean follow-up of 10 years, 7.6% had a major adverse CV event and 9.5% died from any cause.

Leisure-time exercise benefits

After a multivariable adjustment for lifestyle, health, living conditions and socioeconomic factors, compared with low volume of leisure-time physical activity, moderate, high or very high volume of leisure-time physical activity conferred reduced risk for major adverse CV events (HR for moderate = 0.86; 95% CI, 0.78-0.96; HR for high = 0.77; 95% CI, 0.69-0.86; HR for very high = 0.85; 95% CI, 0.73-0.98).

However, the researchers found, compared with low volume, a high or very high volume of occupational physical activity conferred increased risk for major adverse CV events (HR for high = 1.15; 95% CI, 1.04-1.28; HR for very high = 1.35; 95% CI, 1.14-1.59).

Compared with low leisure-time physical activity, moderate, high and very high levels were associated with reduced risk for all-cause mortality (HR for moderate = 0.74; 95% CI, 0.68-0.81; HR for high = 0.59; 95% CI, 0.54-0.64; HR for very high = 0.6; 95% CI, 0.52-0.69), the researchers wrote.

Higher levels of occupational physical activity were associated with elevated all-cause mortality risk compared with low levels (HR for high = 1.13; 95% CI, 1.01-1.27; HR for very high = 1.27; 95% CI, 1.05-1.54).

Manual jobs

“Many people with manual jobs believe they get fit and healthy by their physical activity at work and therefore can relax when they get home. Unfortunately, our results suggest that this is not the case,” Holtermann said in a press release. “And while these workers could benefit from leisure physical activity, after walking 10,000 steps while cleaning or standing 7 hours in a production line, people tend to feel tired, so that’s a barrier.”

According to a related editorial, physical exercise performed during leisure or work time is different in character, as leisure time exercise comprises more aerobic endurance exercise, whereas occupational exercise primarily involves repetitive resistance exercise of short bouts and often insufficient recovery time.

“Moreover, workers in heavy manual jobs may be particularly exposed to psychological factors (eg, night shifts and environmental stressors such as noise or air pollution), which are less frequent in sedentary jobs (eg, office work). These stress factors may clearly affect the relationship between physical work as part of an occupation and cardiovascular risk factors,” Martin Halle, MD, and Melanie Heitkamp, MD, with the department of prevention and sports medicine, University Hospital Klinikum rechts der Isar, Technical University in Munich, wrote.

Findings from the study may be considered by those writing guidelines on CVD prevention in relation to physical activity, the authors wrote.

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