Family History-Guided Physical Activity for Cardiovascular Disease Prevention.

Introduction: It remains unclear if individuals with a family history of cardiovascular disease (CVD) can achieve similar CVD incidence reductions through moderate-to-vigorous physical activity (MVPA) as those without a family history. The aim of the study was to investigate the importance of familial CVD history on the association of MVPA with CVD risk.

Methods: A prospective cohort from the UK Biobank who completed one week of accelerometer-based MVPA measurements from June 1, 2013, to December 23, 2015 was analyzed. The exposures were the different doses of MVPA derived from accelerometry. The main outcomes and measures were the dose-response associations between moderate-to-vigorous MVPA and incident CVD in individuals with and without a family history of CVD.

Results: 74,715 individuals (mean age 55.2 years) were examined. The median follow-up time was 7.9 years. The dose-response association between MVPA and incident CVD among individuals with family history of CVD showed significant risk reductions within the range of 10-1,555 weekly minutes (reference: 0 MVPA minutes). The optimal risk reduction (i.e., nadir of the curve) was identified at 555 weekly minutes of MVPA (HR, 0.72 [95% CI, 0.64-0.81]). The dose-response associations between MVPA and incident CVD among individuals with no family history of CVD showed significant risk reductions within the range of 220-555 weekly minutes. The optimal risk reduction was identified at 445 weekly minutes of MVPA (HR, 0.80 [95% CI, 0.65-0.99]).

Conclusions: Physical activity guidelines should account for familial CVD history, as those with a family history may achieve greater risk reductions.