Over decades, low physical activity boosts mortality risk

PARIS – Lower levels of physical activity over time were linked to a significantly increased risk of both cardiovascular and all-cause mortality, according to results from a prospective cohort study that followed more than 23,000 adults for over 2 decades.

“Individuals who remained physically inactive, or who decreased their physical activity over 22 years, had substantially increased risk of dying from all causes, and from cardiovascular disease,” Trine Moholdt, PhD, said at a press conference at the annual congress of the European Society of Cardiology.

“The bad news is that sustained inactivity was associated with a 99% increase in all-cause mortality and 168% increase in cardiovascular deaths” compared with sustained physical activity, she said.

The news was similarly bad for individuals who had been highly active and then became inactive; this cohort had an increase in all-cause mortality of 116% and sustained a 173% increase in cardiovascular deaths. “Previous activity levels – they don’t count. You have to keep it up,” said Dr. Moholdt, speaking in a video interview.

However, the risk associated with inactivity was attenuated for those patients who became more active over the course of the study period; their risk was still higher than that of those who had sustained activity, but lower than those who remained inactive. “It’s never too late to start being physically active,” said Dr. Moholdt.

All groups were compared with individuals who remained highly active over the study period; this reference group had the lowest risk of both cardiovascular and all-cause death.

Dr. Moholdt noted a limitation of most previous research into how physical activity relates to cardiovascular and all-cause mortality: Data are obtained just at baseline, and then associated with a downstream outcome. “But people change!” she said, so it’s important to track how activity levels change over time.

To that end, the Nord-Trøndelag Health Study (HUNT study) measured activity levels for 23,156 participants at two points, and then assessed cardiovascular and all-cause mortality, over a period of 22 years.

 

Dr. Moholdt, head of the Exercise, Cardiometabolic Health and Reproduction research group at Norwegian University of Science and Technology, Trondheim, and her collaborators asked individuals about physical activity in 1985, and again in 2007. At each time point, investigators asked participants to report how many hours per week they spent in “mosjon,” the Norwegian word for “motion”; Dr. Moholdt explained that the word carries the connotation of purposeful, health-promoting physical activity.

Individuals were grouped into one of three activity levels at each time point: Inactive participants reported no purposeful physical activity, moderately active participants reported less than 2 hours per week of this activity, and the most highly active group was active for 2 or more hours per week.

Patients who were in each of the three activity groupings at baseline might have changed their activity levels by the second assessment, so the investigators tracked a total of nine categories of exercise trends over time.

The mean age of participants in the Nord-Trøndelag Health Study (HUNT study) was 39 years, and the mean body mass index was 24 kg/m². Of the 23,156 participants, 12,665 were women. Dr. Moholdt and her colleagues used statistical analysis to adjust for age, sex, body mass index, smoking, educational status, and systolic blood pressure.

However, Dr. Moholdt acknowledged at the press conference that comorbidities not captured in the study design might impact changes in activity levels, particularly for formerly highly active patients who became inactive over the study period.

The study was presented in a poster session at the congress. Dr. Moholdt reported no conflicts of interest. The study was funded by Health Central Norway (Helse-Midt Norge), a state entity that operates health care facilities in the region of Norway where the HUNT study was conducted.

koakes@mdedge.com

SOURCE: Moholdt T. et al. ESC Congress 2019, Abstract P627.

PARIS – Lower levels of physical activity over time were linked to a significantly increased risk of both cardiovascular and all-cause mortality, according to results from a prospective cohort study that followed more than 23,000 adults for over 2 decades.

“Individuals who remained physically inactive, or who decreased their physical activity over 22 years, had substantially increased risk of dying from all causes, and from cardiovascular disease,” Trine Moholdt, PhD, said at a press conference at the annual congress of the European Society of Cardiology.

“The bad news is that sustained inactivity was associated with a 99% increase in all-cause mortality and 168% increase in cardiovascular deaths” compared with sustained physical activity, she said.

The news was similarly bad for individuals who had been highly active and then became inactive; this cohort had an increase in all-cause mortality of 116% and sustained a 173% increase in cardiovascular deaths. “Previous activity levels – they don’t count. You have to keep it up,” said Dr. Moholdt, speaking in a video interview.

However, the risk associated with inactivity was attenuated for those patients who became more active over the course of the study period; their risk was still higher than that of those who had sustained activity, but lower than those who remained inactive. “It’s never too late to start being physically active,” said Dr. Moholdt.

All groups were compared with individuals who remained highly active over the study period; this reference group had the lowest risk of both cardiovascular and all-cause death.

Dr. Moholdt noted a limitation of most previous research into how physical activity relates to cardiovascular and all-cause mortality: Data are obtained just at baseline, and then associated with a downstream outcome. “But people change!” she said, so it’s important to track how activity levels change over time.

To that end, the Nord-Trøndelag Health Study (HUNT study) measured activity levels for 23,156 participants at two points, and then assessed cardiovascular and all-cause mortality, over a period of 22 years.

 

Dr. Moholdt, head of the Exercise, Cardiometabolic Health and Reproduction research group at Norwegian University of Science and Technology, Trondheim, and her collaborators asked individuals about physical activity in 1985, and again in 2007. At each time point, investigators asked participants to report how many hours per week they spent in “mosjon,” the Norwegian word for “motion”; Dr. Moholdt explained that the word carries the connotation of purposeful, health-promoting physical activity.

Individuals were grouped into one of three activity levels at each time point: Inactive participants reported no purposeful physical activity, moderately active participants reported less than 2 hours per week of this activity, and the most highly active group was active for 2 or more hours per week.

Patients who were in each of the three activity groupings at baseline might have changed their activity levels by the second assessment, so the investigators tracked a total of nine categories of exercise trends over time.

The mean age of participants in the Nord-Trøndelag Health Study (HUNT study) was 39 years, and the mean body mass index was 24 kg/m². Of the 23,156 participants, 12,665 were women. Dr. Moholdt and her colleagues used statistical analysis to adjust for age, sex, body mass index, smoking, educational status, and systolic blood pressure.

However, Dr. Moholdt acknowledged at the press conference that comorbidities not captured in the study design might impact changes in activity levels, particularly for formerly highly active patients who became inactive over the study period.

The study was presented in a poster session at the congress. Dr. Moholdt reported no conflicts of interest. The study was funded by Health Central Norway (Helse-Midt Norge), a state entity that operates health care facilities in the region of Norway where the HUNT study was conducted.

koakes@mdedge.com

SOURCE: Moholdt T. et al. ESC Congress 2019, Abstract P627.

PARIS – Lower levels of physical activity over time were linked to a significantly increased risk of both cardiovascular and all-cause mortality, according to results from a prospective cohort study that followed more than 23,000 adults for over 2 decades.

“Individuals who remained physically inactive, or who decreased their physical activity over 22 years, had substantially increased risk of dying from all causes, and from cardiovascular disease,” Trine Moholdt, PhD, said at a press conference at the annual congress of the European Society of Cardiology.

“The bad news is that sustained inactivity was associated with a 99% increase in all-cause mortality and 168% increase in cardiovascular deaths” compared with sustained physical activity, she said.

The news was similarly bad for individuals who had been highly active and then became inactive; this cohort had an increase in all-cause mortality of 116% and sustained a 173% increase in cardiovascular deaths. “Previous activity levels – they don’t count. You have to keep it up,” said Dr. Moholdt, speaking in a video interview.

However, the risk associated with inactivity was attenuated for those patients who became more active over the course of the study period; their risk was still higher than that of those who had sustained activity, but lower than those who remained inactive. “It’s never too late to start being physically active,” said Dr. Moholdt.

All groups were compared with individuals who remained highly active over the study period; this reference group had the lowest risk of both cardiovascular and all-cause death.

Dr. Moholdt noted a limitation of most previous research into how physical activity relates to cardiovascular and all-cause mortality: Data are obtained just at baseline, and then associated with a downstream outcome. “But people change!” she said, so it’s important to track how activity levels change over time.

To that end, the Nord-Trøndelag Health Study (HUNT study) measured activity levels for 23,156 participants at two points, and then assessed cardiovascular and all-cause mortality, over a period of 22 years.

 

Dr. Moholdt, head of the Exercise, Cardiometabolic Health and Reproduction research group at Norwegian University of Science and Technology, Trondheim, and her collaborators asked individuals about physical activity in 1985, and again in 2007. At each time point, investigators asked participants to report how many hours per week they spent in “mosjon,” the Norwegian word for “motion”; Dr. Moholdt explained that the word carries the connotation of purposeful, health-promoting physical activity.

Individuals were grouped into one of three activity levels at each time point: Inactive participants reported no purposeful physical activity, moderately active participants reported less than 2 hours per week of this activity, and the most highly active group was active for 2 or more hours per week.

Patients who were in each of the three activity groupings at baseline might have changed their activity levels by the second assessment, so the investigators tracked a total of nine categories of exercise trends over time.

The mean age of participants in the Nord-Trøndelag Health Study (HUNT study) was 39 years, and the mean body mass index was 24 kg/m². Of the 23,156 participants, 12,665 were women. Dr. Moholdt and her colleagues used statistical analysis to adjust for age, sex, body mass index, smoking, educational status, and systolic blood pressure.

However, Dr. Moholdt acknowledged at the press conference that comorbidities not captured in the study design might impact changes in activity levels, particularly for formerly highly active patients who became inactive over the study period.

The study was presented in a poster session at the congress. Dr. Moholdt reported no conflicts of interest. The study was funded by Health Central Norway (Helse-Midt Norge), a state entity that operates health care facilities in the region of Norway where the HUNT study was conducted.

koakes@mdedge.com

SOURCE: Moholdt T. et al. ESC Congress 2019, Abstract P627.