PHYSICAL ACTIVITY IS ASSOCIATED WITH IMPROVED SECONDARY PREVENTION OF CARDIOVASCULAR DISEASE IN THE UK BIOBANK

Physical activity (PA) is known to be associated with a decreased risk of all-cause and cardiovascular mortality in apparently healthy adults. The association between PA and risk of death for individuals with prevalent cardiovascular disease (CVD) at baseline is less well understood. Therefore, the aim of this study was to determine the association between PA levels and survival in individuals with prevalent CVD at baseline. A survival analysis involving 38,291 UK Biobank participants with prevalent CVD at baseline was conducted. Physical activity was assessed using accelerometry-calibrated PA which measures total energy expended in PA. Prevalent CVD, all-cause mortality, and CVD mortality were determined through ICD-10 codes and data linkage through death and hospital records. Cox proportional hazard models were used to estimate the risk of all-cause, overall cardiovascular, and specific CVD category mortality for quartiles of PA after adjusting for known confounders. There were 6,540 all-cause deaths and 3,559 cardiovascular deaths with median follow up time of 11.98 years. The risk of all-cause and overall cardiovascular mortality reduced with increasing dose of PA (highest vs lowest PA; HR = 0.70, 95% CI: 0.64 - 0.76 and 0.70, 95% CI: 0.62 - 0.79, respectively). Those in the highest quartile of PA had a 41% reduced risk of dying from cerebrovascular disease and a 38% reduced risk of dying from and hypertensive diseases (including hypertensive heart disease with heart failure). Higher levels of PA are associated with lower risk of all-cause and overall cardiovascular mortality in individuals with prevalent CVD at baseline. These findings highlight the importance of PA in secondary prevention of cardiovascular disease.