Does total volume of physical activity matter more than pattern for onset of CVD? A prospective cohort study of older British men
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AIMS: With increasing age, physical inactivity and sedentary behaviour levels increase, as does cardiovascular disease (CVD) incidence. We investigate how device-measured sedentary behaviour and physical activity (PA) are related to CVD onset in men aged 70+; whether the total volume of activity is more important than pattern. METHODS AND RESULTS: Prospective population-based cohort study of men recruited from 24 UK General Practices in 1978-80. In 2010-12, 3137 survivors were invited to complete questionnaires and wear an Actigraph GT3x accelerometer for 7 days. PA intensity was categorised as sedentary, light and moderate to vigorous (MVPA). Men were followed up for Myocardial Infarction, stroke and heart failure (ICD9 410-414, 430-438 and 428) morbidity and mortality from 2010 to 12 to June 2016. Hazard Ratios (HRs) for incident Cardiovascular Disease (CVD) were estimated. 1528/3137 (49%) men had sufficient accelerometer data. 254 men with pre-existing CVD were excluded. Participants' mean age was 78.4 (range 71-92) years. After median 4.9 years follow-up, 122 first CVD events occurred in 1181 men (22.7/1000 person-years) with complete data. For each additional 30 min in sedentary behaviour, light PA,10 min in MVPA, or 1000 steps/day, HRs for CVD were 1.09(95%CI 1.00, 1.19), 0.94(0.85, 1.04), 0.88(0.81, 0.96) and 0.86(0.78 to 0.95) respectively, adjusted for measurement-related factors, socio-demographics, health behaviours and disability. HRs for accumulating 150 min/week MVPA in bouts ≥1 min and bouts ≥10 min were 0.47(0.32 to 0.69), and 0.49(0.25, 0.98). CONCLUSIONS: In older men, high volume of steps or MVPA rather than MVPA bouts was associated with reduced CVD risk.
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The existing evidence regarding associations between light-intensity physical activity and risks for developing cardiovascular events in the general population is conflicting.
“The existing evidence regarding associations between LPA and risks for developing cardiovascular events in the general population is conflicting.13, 14, 15, 16”
From Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes (2025) · cites this paper as [15]
The Discussion (PA intensity and duration) reports mixed findings for light-intensity physical activity: this study and one NHANES analysis found no association, while other analyses found lower CVD mortality or less consistent associations. That supports the claim that evidence is conflicting, but the comparisons largely concern CVD mortality in older groups rather than the onset of cardiovascular events in the general population. (LLM, conf=0.85)
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- Authors
- Jefferis, B. J., Parsons, T. J., Sartini, C., Ash, S., Lennon, L. T., Papacosta, O., Morris, R. W., Wannamethee, S. G., Lee, I.-M., & Whincup, P. H.
- Affiliations
- University College London (GB)
- University of Bristol (GB)
- Brigham and Women's Hospital (US)
- St George's, University of London (GB)
- Corresponding author
- Jefferis, Barbara J.
- ORCID
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 278
- Pages
- 267-272
- ISSN
- 0167-5273 (ISSN-L)
- PMC
- PMC6350006
- OpenAlex
- W2904427118
- Cited by
- 65
- References
- 41
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 6 · 2023: 5 · 2022: 18 · 2021: 10 · 2020: 8 · 2019: 4
- FWCI
- 3.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Cardiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Explore Bristol Research (submittedVersion, cc-by)
- Funders
- British Heart Foundation (PG/13/86/30546, RG/13/16/30528)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Keywords
- physical activity, sedentary behavior, older men, moderate-to-vigorous physical activity, activity bouts, accelerometer-measured activity, myocardial infarction, stroke, heart failure, physical inactivity, step count
- MeSH terms
- Aged, Aged, 80 and over, Cardiovascular Diseases, Follow-Up Studies, United Kingdom, Humans, Male, Mortality, Prospective Studies, Surveys and Questionnaires, Cohort Studies, Exercise, Sedentary Behavior, General Practice, Accelerometry
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