Jason M Nagata, Eric Vittinghoff, Kelley Pettee Gabriel, Jamal S Rana, Andrea K Garber, Andrew E Moran, Jared P Reis, Cora E Lewis, Stephen Sidney, Kirsten Bibbins-Domingo
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The objective of this study was to determine the association between level and change in physical activity from young adulthood to middle age and incidence of premature CVD events before age 60.</p><p><strong>Methods: </strong>We analyzed data collected across four urban sites from nine visits over 30 years of follow-up (1985-2016) from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort study of 5115 Black and White women and men aged 18-30 years at baseline (1985-1986). Linear mixed models were used to develop individualized moderate-to-vigorous intensity self-reported physical activity trajectories per participant. Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome.</p><p><strong>Results: </strong>Overall, physical activity declined in young adults as they progressed through middle age. Lower physical activity scores (per 100 exercise units) in 18 year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02-1.28), heart failure (AOR 1.21, 95% CI 1.05-1.38), stroke (AOR 1.20, 95% CI 1.04-1.39), and any CVD (AOR 1.15, 95% CI 1.06-1.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02-1.13), stroke (1.06, 95% CI 1.00-1.13), and CVD (1.04, 95% CI 1.01-1.07) events. Meeting the minimum (AOR 0.74, 95% CI 0.0.57-0.96) and twice the minimum (AOR 0.55, 95% CI 0.34-0.91) Department of Health and Human Services physical activity guidelines through follow up was protective of premature CVD events.</p><p><strong>Conclusions: </strong>Given recent trends in declining physical activity with age and associated premature CVD events, the transition from young adult to midlife is an important time period to promote physical activity.</p>","PeriodicalId":520799,"journal":{"name":"The international journal of behavioral nutrition and physical activity","volume":" ","pages":"123"},"PeriodicalIF":5.5000,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9487136/pdf/","citationCount":"5","resultStr":"{\"title\":\"Physical activity from young adulthood to middle age and premature cardiovascular disease events: a 30-year population-based cohort study.\",\"authors\":\"Jason M Nagata, Eric Vittinghoff, Kelley Pettee Gabriel, Jamal S Rana, Andrea K Garber, Andrew E Moran, Jared P Reis, Cora E Lewis, Stephen Sidney, Kirsten Bibbins-Domingo\",\"doi\":\"10.1186/s12966-022-01357-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Although physical activity is generally protective of cardiovascular disease (CVD), less is known about how young adult physical activity relates to premature CVD events. 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Lower physical activity scores (per 100 exercise units) in 18 year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02-1.28), heart failure (AOR 1.21, 95% CI 1.05-1.38), stroke (AOR 1.20, 95% CI 1.04-1.39), and any CVD (AOR 1.15, 95% CI 1.06-1.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02-1.13), stroke (1.06, 95% CI 1.00-1.13), and CVD (1.04, 95% CI 1.01-1.07) events. 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引用次数: 5
摘要
背景:虽然体育活动通常对心血管疾病(CVD)有保护作用，但对于年轻人体育活动与过早的CVD事件之间的关系知之甚少。本研究的目的是确定从青年到中年的体力活动水平和变化与60岁前过早心血管事件发生率之间的关系。方法:我们分析了从青年冠状动脉风险发展(CARDIA)研究中收集的4个城市站点收集的数据，这些数据来自30年随访(1985-2016)的9次访问，这是一项前瞻性社区队列研究，在基线(1985-1986)对5115名18-30岁的黑人和白人女性和男性进行了研究。线性混合模型用于开发每个参与者的个体化的中等至剧烈强度自我报告的身体活动轨迹。分别分析致死性和非致死性冠心病(CHD)、心力衰竭和卒中结局，并将其作为合并CVD事件结局。结果:总体而言，随着年轻人进入中年，他们的体力活动减少了。18岁青少年较低的身体活动评分(每100个运动单位)与较高的早期冠心病(AOR 1.14, 95% CI 1.02-1.28)、心力衰竭(AOR 1.21, 95% CI 1.05-1.38)、中风(AOR 1.20, 95% CI 1.04-1.39)和任何CVD (AOR 1.15, 95% CI 1.06-1.24)事件的发生率相关。体力活动评分每增加1个单位，每年发生心力衰竭(1.07,95% CI 1.02-1.13)、中风(1.06,95% CI 1.00-1.13)和心血管疾病(1.04,95% CI 1.01-1.07)事件的几率就会增加。通过随访达到最低限度(AOR 0.74, 95% CI 0.57-0.96)和两倍于最低限度(AOR 0.55, 95% CI 0.34-0.91)的卫生与公众服务部体力活动指南可预防心血管疾病过早发生。结论:鉴于近年来体力活动随年龄增长而减少的趋势以及相关的过早心血管疾病事件，从青年到中年的过渡是促进体力活动的重要时期。
Physical activity from young adulthood to middle age and premature cardiovascular disease events: a 30-year population-based cohort study.
Background: Although physical activity is generally protective of cardiovascular disease (CVD), less is known about how young adult physical activity relates to premature CVD events. The objective of this study was to determine the association between level and change in physical activity from young adulthood to middle age and incidence of premature CVD events before age 60.
Methods: We analyzed data collected across four urban sites from nine visits over 30 years of follow-up (1985-2016) from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort study of 5115 Black and White women and men aged 18-30 years at baseline (1985-1986). Linear mixed models were used to develop individualized moderate-to-vigorous intensity self-reported physical activity trajectories per participant. Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome.
Results: Overall, physical activity declined in young adults as they progressed through middle age. Lower physical activity scores (per 100 exercise units) in 18 year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02-1.28), heart failure (AOR 1.21, 95% CI 1.05-1.38), stroke (AOR 1.20, 95% CI 1.04-1.39), and any CVD (AOR 1.15, 95% CI 1.06-1.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02-1.13), stroke (1.06, 95% CI 1.00-1.13), and CVD (1.04, 95% CI 1.01-1.07) events. Meeting the minimum (AOR 0.74, 95% CI 0.0.57-0.96) and twice the minimum (AOR 0.55, 95% CI 0.34-0.91) Department of Health and Human Services physical activity guidelines through follow up was protective of premature CVD events.
Conclusions: Given recent trends in declining physical activity with age and associated premature CVD events, the transition from young adult to midlife is an important time period to promote physical activity.
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