Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences.
Level 3 - non-randomized controlled study
Prospective cohort study using device-measured exposure and longitudinal follow-up.
PubMed 39467622 · doi:10.1136/bjsports-2024-108484
What was done
This prospective cohort study examined UK Biobank accelerometry data from 22,368 self-reported non-exercisers (13,018 women and 9,350 men reporting no leisure-time exercise and no more than one recreational walk per week). Researchers evaluated dose-response associations of device-measured daily vigorous intermittent lifestyle physical activity (VILPA) duration with incident major adverse cardiovascular events (MACE; including myocardial infarction, heart failure, and stroke) over a 7.9-year follow-up using multivariable-adjusted cubic splines. Parallel analyses were performed in regular exercisers.
What was found
Over 7.9 years, 331 MACE occurred in women and 488 in men. Non-exercising women showed a near-linear dose-response reduction in risk for all MACE, myocardial infarction, and heart failure, whereas associations in men were less clear and lacked statistical significance. Compared to women with no VILPA, a median daily VILPA of 3.4 min was associated with hazard ratios (HRs; 95% CI) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Minimum daily doses of 1.2 to 1.6 min in women were associated with HRs of 0.70 (0.58 to 0.86) for MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. No apparent sex differences in dose-response were seen among exercisers.
Why it matters
As little as 1 to 3 minutes of daily incidental vigorous physical activity is associated with substantial cardiovascular risk reduction in women who do not engage in structured exercise, highlighting a pragmatic target for cardiovascular disease prevention.
Limits
The observational design cannot establish causality and remains subject to potential residual confounding or reverse causation. Accelerometry was recorded during a single baseline period, which may not capture activity changes across the 7.9-year follow-up. UK Biobank participants represent a healthier-than-average volunteer cohort.
Cited by
- supports In a study of women, engaging in 3.4 minutes per day of VILPA was associated with a 45% lower risk of major cardiovascular events and a 67% lower risk of heart failure.
- supports Data in women show that accumulating as little as 4 minutes of vigorous physical activity per day meaningfully reduces the risk of heart attacks.