Association of Habitual Physical Activity With Cardiovascular Disease Risk

Honghuang Lin; Mayank Sardana; Yuankai Zhang; Chunyu Liu; Ludovic Trinquart; Emelia J Benjamin; Emily S Manders; Kelsey Fusco; Jelena Kornej; Michael M Hammond; Nicole L Spartano; Chathurangi H Pathiravasan; Vik Kheterpal; Chris Nowak; Belinda Borrelli; Joanne M Murabito; David D McManus

doi:10.1161/CIRCRESAHA.120.317578

Association of Habitual Physical Activity With Cardiovascular Disease Risk

Honghuang Lin, Mayank Sardana, Yuankai Zhang, Chunyu Liu, Ludovic Trinquart, Emelia J Benjamin, Emily S Manders, Kelsey Fusco, Jelena Kornej, Michael M Hammond, Nicole L Spartano, Chathurangi H Pathiravasan, Vik Kheterpal, Chris Nowak, Belinda Borrelli, Joanne M Murabito, David D McManus

Division of Psychology & Mental Health (L5)

Research output: Contribution to journal › Article › peer-review

Abstract

RATIONALE: A sedentary lifestyle is associated with increased risk for cardiovascular disease (CVD). Smartwatches enable accurate daily activity monitoring for physical activity measurement and intervention. Few studies, however, have examined physical activity measures from smartwatches in relation to traditional risk factors associated with future risk for CVD.

OBJECTIVE: To investigate the association of habitual physical activity measured by smartwatch with predicted CVD risk in adults.

METHODS AND RESULTS: We enrolled consenting FHS (Framingham Heart Study) participants in an ongoing eFHS (electronic Framingham Heart Study) at the time of their FHS research center examination. We provided participants with a smartwatch (Apple Watch Series 0) and instructed them to wear it daily, which measured their habitual physical activity as the average daily step count. We estimated the 10-year predicted risk of CVD using the American College of Cardiology/American Heart Association 2013 pooled cohort risk equation. We estimated the association between physical activity and predicted risk of CVD using linear mixed effects models adjusting for age, sex, wear time, and familial structure. Our study included 903 eFHS participants (mean age 53±9 years, 61% women, 9% non-White) who wore the smartwatch ≥5 hours per day for ≥30 days. Median daily step count was similar among men (7202 with interquartile range 3619) and women (7260 with interquartile range 3068; P=0.52). Average 10-year predicted CVD risk was 4.5% (interquartile range, 6.1%) for men and 1.2% (interquartile range, 2.2%) for women (P=1.3×10-26). Every 1000 steps higher habitual physical activity was associated with 0.18% lower predicted CVD risk (P=3.2×10-4). The association was attenuated but remained significant after further adjustment for body mass index (P=0.01).

CONCLUSIONS: In this community-based sample of adults, higher daily physical activity measured by a study smartwatch was associated with lower predicted risk of CVD. Future research should examine the longitudinal association of prospectively measured daily activity and incident CVD.

Original language	English
Pages (from-to)	1253-1260
Number of pages	8
Journal	Circulation research
Volume	127
Issue number	10
DOIs	https://doi.org/10.1161/CIRCRESAHA.120.317578
Publication status	Published - 23 Oct 2020

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10.1161/CIRCRESAHA.120.317578

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Lin, H., Sardana, M., Zhang, Y., Liu, C., Trinquart, L., Benjamin, E. J., Manders, E. S., Fusco, K., Kornej, J., Hammond, M. M., Spartano, N. L., Pathiravasan, C. H., Kheterpal, V., Nowak, C., Borrelli, B., Murabito, J. M., & McManus, D. D. (2020). Association of Habitual Physical Activity With Cardiovascular Disease Risk. Circulation research, 127(10), 1253-1260. https://doi.org/10.1161/CIRCRESAHA.120.317578

@article{2e581a9817884c579ccf50f397b3a379,

title = "Association of Habitual Physical Activity With Cardiovascular Disease Risk",

abstract = "RATIONALE: A sedentary lifestyle is associated with increased risk for cardiovascular disease (CVD). Smartwatches enable accurate daily activity monitoring for physical activity measurement and intervention. Few studies, however, have examined physical activity measures from smartwatches in relation to traditional risk factors associated with future risk for CVD.OBJECTIVE: To investigate the association of habitual physical activity measured by smartwatch with predicted CVD risk in adults.METHODS AND RESULTS: We enrolled consenting FHS (Framingham Heart Study) participants in an ongoing eFHS (electronic Framingham Heart Study) at the time of their FHS research center examination. We provided participants with a smartwatch (Apple Watch Series 0) and instructed them to wear it daily, which measured their habitual physical activity as the average daily step count. We estimated the 10-year predicted risk of CVD using the American College of Cardiology/American Heart Association 2013 pooled cohort risk equation. We estimated the association between physical activity and predicted risk of CVD using linear mixed effects models adjusting for age, sex, wear time, and familial structure. Our study included 903 eFHS participants (mean age 53±9 years, 61% women, 9% non-White) who wore the smartwatch ≥5 hours per day for ≥30 days. Median daily step count was similar among men (7202 with interquartile range 3619) and women (7260 with interquartile range 3068; P=0.52). Average 10-year predicted CVD risk was 4.5% (interquartile range, 6.1%) for men and 1.2% (interquartile range, 2.2%) for women (P=1.3×10-26). Every 1000 steps higher habitual physical activity was associated with 0.18% lower predicted CVD risk (P=3.2×10-4). The association was attenuated but remained significant after further adjustment for body mass index (P=0.01).CONCLUSIONS: In this community-based sample of adults, higher daily physical activity measured by a study smartwatch was associated with lower predicted risk of CVD. Future research should examine the longitudinal association of prospectively measured daily activity and incident CVD.",

author = "Honghuang Lin and Mayank Sardana and Yuankai Zhang and Chunyu Liu and Ludovic Trinquart and Benjamin, {Emelia J} and Manders, {Emily S} and Kelsey Fusco and Jelena Kornej and Hammond, {Michael M} and Spartano, {Nicole L} and Pathiravasan, {Chathurangi H} and Vik Kheterpal and Chris Nowak and Belinda Borrelli and Murabito, {Joanne M} and McManus, {David D}",

year = "2020",

month = oct,

day = "23",

doi = "10.1161/CIRCRESAHA.120.317578",

language = "English",

volume = "127",

pages = "1253--1260",

journal = "Circulation research",

issn = "0009-7330",

publisher = "Lippincott Williams & Wilkins",

number = "10",

}

Lin, H, Sardana, M, Zhang, Y, Liu, C, Trinquart, L, Benjamin, EJ, Manders, ES, Fusco, K, Kornej, J, Hammond, MM, Spartano, NL, Pathiravasan, CH, Kheterpal, V, Nowak, C, Borrelli, B, Murabito, JM & McManus, DD 2020, 'Association of Habitual Physical Activity With Cardiovascular Disease Risk', Circulation research, vol. 127, no. 10, pp. 1253-1260. https://doi.org/10.1161/CIRCRESAHA.120.317578

TY - JOUR

T1 - Association of Habitual Physical Activity With Cardiovascular Disease Risk

AU - Lin, Honghuang

AU - Sardana, Mayank

AU - Zhang, Yuankai

AU - Liu, Chunyu

AU - Trinquart, Ludovic

AU - Benjamin, Emelia J

AU - Manders, Emily S

AU - Fusco, Kelsey

AU - Kornej, Jelena

AU - Hammond, Michael M

AU - Spartano, Nicole L

AU - Pathiravasan, Chathurangi H

AU - Kheterpal, Vik

AU - Nowak, Chris

AU - Borrelli, Belinda

AU - Murabito, Joanne M

AU - McManus, David D

PY - 2020/10/23

Y1 - 2020/10/23

N2 - RATIONALE: A sedentary lifestyle is associated with increased risk for cardiovascular disease (CVD). Smartwatches enable accurate daily activity monitoring for physical activity measurement and intervention. Few studies, however, have examined physical activity measures from smartwatches in relation to traditional risk factors associated with future risk for CVD.OBJECTIVE: To investigate the association of habitual physical activity measured by smartwatch with predicted CVD risk in adults.METHODS AND RESULTS: We enrolled consenting FHS (Framingham Heart Study) participants in an ongoing eFHS (electronic Framingham Heart Study) at the time of their FHS research center examination. We provided participants with a smartwatch (Apple Watch Series 0) and instructed them to wear it daily, which measured their habitual physical activity as the average daily step count. We estimated the 10-year predicted risk of CVD using the American College of Cardiology/American Heart Association 2013 pooled cohort risk equation. We estimated the association between physical activity and predicted risk of CVD using linear mixed effects models adjusting for age, sex, wear time, and familial structure. Our study included 903 eFHS participants (mean age 53±9 years, 61% women, 9% non-White) who wore the smartwatch ≥5 hours per day for ≥30 days. Median daily step count was similar among men (7202 with interquartile range 3619) and women (7260 with interquartile range 3068; P=0.52). Average 10-year predicted CVD risk was 4.5% (interquartile range, 6.1%) for men and 1.2% (interquartile range, 2.2%) for women (P=1.3×10-26). Every 1000 steps higher habitual physical activity was associated with 0.18% lower predicted CVD risk (P=3.2×10-4). The association was attenuated but remained significant after further adjustment for body mass index (P=0.01).CONCLUSIONS: In this community-based sample of adults, higher daily physical activity measured by a study smartwatch was associated with lower predicted risk of CVD. Future research should examine the longitudinal association of prospectively measured daily activity and incident CVD.

AB - RATIONALE: A sedentary lifestyle is associated with increased risk for cardiovascular disease (CVD). Smartwatches enable accurate daily activity monitoring for physical activity measurement and intervention. Few studies, however, have examined physical activity measures from smartwatches in relation to traditional risk factors associated with future risk for CVD.OBJECTIVE: To investigate the association of habitual physical activity measured by smartwatch with predicted CVD risk in adults.METHODS AND RESULTS: We enrolled consenting FHS (Framingham Heart Study) participants in an ongoing eFHS (electronic Framingham Heart Study) at the time of their FHS research center examination. We provided participants with a smartwatch (Apple Watch Series 0) and instructed them to wear it daily, which measured their habitual physical activity as the average daily step count. We estimated the 10-year predicted risk of CVD using the American College of Cardiology/American Heart Association 2013 pooled cohort risk equation. We estimated the association between physical activity and predicted risk of CVD using linear mixed effects models adjusting for age, sex, wear time, and familial structure. Our study included 903 eFHS participants (mean age 53±9 years, 61% women, 9% non-White) who wore the smartwatch ≥5 hours per day for ≥30 days. Median daily step count was similar among men (7202 with interquartile range 3619) and women (7260 with interquartile range 3068; P=0.52). Average 10-year predicted CVD risk was 4.5% (interquartile range, 6.1%) for men and 1.2% (interquartile range, 2.2%) for women (P=1.3×10-26). Every 1000 steps higher habitual physical activity was associated with 0.18% lower predicted CVD risk (P=3.2×10-4). The association was attenuated but remained significant after further adjustment for body mass index (P=0.01).CONCLUSIONS: In this community-based sample of adults, higher daily physical activity measured by a study smartwatch was associated with lower predicted risk of CVD. Future research should examine the longitudinal association of prospectively measured daily activity and incident CVD.

U2 - 10.1161/CIRCRESAHA.120.317578

DO - 10.1161/CIRCRESAHA.120.317578

M3 - Article

C2 - 32842915

SN - 0009-7330

VL - 127

SP - 1253

EP - 1260

JO - Circulation research

JF - Circulation research

IS - 10

ER -

Association of Habitual Physical Activity With Cardiovascular Disease Risk

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