Accelerometer derived physical activity and subclinical coronary and carotid atherosclerosis: cross-sectional analyses in 22 703 middle-aged men and women in the SCAPIS study
Gunnar Engström,
Tomas Jernberg,
Mats Borjesson,
Jonas Persson,
Camilla Sandberg,
Örjan Ekblom,
Patrik Wennberg,
Amra Jujic,
Margaretha Persson,
Jan Engvall,
Carl Johan Östgren,
Lars Lind,
Oskar Angerås,
Ellen Ostenfeld,
Elin Ekblom-Bak,
Bjorn Redfors,
Anders Persson,
Carl-Johan Carlhall,
Maria Mannila,
Peter Johansson,
Frida Bergman,
Caroline Berntsson,
Erika Fagman,
Agneta Flinck,
Tanja Kero,
Jerry Öhlin
Affiliations
Gunnar Engström
Department of Clinical Sciences, Lund University, Malmö, Sweden
Tomas Jernberg
Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden
Mats Borjesson
Institute of Medicine, University of Gothenburg, Goteborg, Sweden
Jonas Persson
Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden
Camilla Sandberg
Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
Örjan Ekblom
Department of Physical Activity and Health, Swedish School of Sport and Health Sciences GIH, Stockholm, Sweden
Patrik Wennberg
Public Health and Clinical Medicine, Family Medicine, Umeå University, Umea, Sweden
Amra Jujic
Department of Clinical Sciences, Lund University, Malmö, Sweden
Margaretha Persson
Department of Clinical Sciences, Lund University, Malmö, Sweden
Jan Engvall
Department of Health, Medicine and Caring Sciences and Department of Clinical Physiology, Linköping University, Linkoping, Sweden
Carl Johan Östgren
Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden
Lars Lind
Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden
Oskar Angerås
Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden
Ellen Ostenfeld
Department of Clinical Physiology, Skåne University Hospital, Lund, Sweden
Elin Ekblom-Bak
Department of Physical Activity and Health, Swedish School of Sport and Health Sciences GIH, Stockholm, Sweden
Bjorn Redfors
Region Västra Götaland, Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden
Anders Persson
Center for Medical Image Science and Visualization, Linköping University, Linkoping, Sweden
Carl-Johan Carlhall
Department of Health, Medicine and Caring Sciences and Department of Clinical Physiology, Linköping University, Linkoping, Sweden
Maria Mannila
Department of Cardiology and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
Peter Johansson
Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Frida Bergman
Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
Caroline Berntsson
Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden
Erika Fagman
Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden
Agneta Flinck
Department of Radiology, Sahlgrenska University Hospital, Goteborg, Sweden
Tanja Kero
Medical Image Centre, Uppsala University Hospital, Uppsala, Sweden
Jerry Öhlin
Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
Objectives The aim included investigation of the associations between sedentary (SED), low-intensity physical activity (LIPA), moderate-to-vigorous intensity PA (MVPA) and the prevalence of subclinical atherosclerosis in both coronaries and carotids and the estimated difference in prevalence by theoretical reallocation of time in different PA behaviours.Design Cross-sectional.Setting Multisite study at university hospitals.Participants A total of 22 670 participants without cardiovascular disease (51% women, 57.4 years, SD 4.3) from the population-based Swedish CArdioPulmonary bioImage study were included. SED, LIPA and MVPA were assessed by hip-worn accelerometer.Primary and secondary outcomes Any and significant subclinical coronary atherosclerosis (CA), Coronary Artery Calcium Score (CACS) and carotid atherosclerosis (CarA) were derived from imaging data from coronary CT angiography and carotid ultrasound.Results High daily SED (>70% ≈10.5 hours/day) associated with a higher OR 1.44 (95% CI 1.09 to 1.91), for significant CA, and with lower OR 0.77 (95% CI 0.63 to 0.95), for significant CarA. High LIPA (>55% ≈8 hours/day) associated with lower OR for significant CA 0.70 (95% CI 0.51 to 0.96), and CACS, 0.71 (95% CI 0.51 to 0.97), but with higher OR for CarA 1.41 (95% CI 1.12 to 1.76). MVPA above reference level, >2% ≈20 min/day, associated with lower OR for significant CA (OR range 0.61–0.67), CACS (OR range 0.71–0.75) and CarA (OR range 0.72–0.79). Theoretical replacement of 30 min of SED into an equal amount of MVPA associated with lower OR for significant CA, especially in participants with high SED 0.84 (95% CI 0.76 to 0.96) or low MVPA 0.51 (0.36 to 0.73).Conclusions MVPA was associated with a lower risk for significant atherosclerosis in both coronaries and carotids, while the association varied in strength and direction for SED and LIPA, respectively. If causal, clinical implications include avoiding high levels of daily SED and low levels of MVPA to reduce the risk of developing significant subclinical atherosclerosis.
