Background Whether all domains of daily‐life moderate‐to‐vigorous physical activity ( MVPA ) are associated with lower blood pressure ( BP ) and how this association depends on age and body mass index remains unclear. Methods and Results In the population‐based Lifelines cohort (N=125 402), MVPA was assessed by the Short Questionnaire to Assess Health‐Enhancing Physical Activity, a validated questionnaire in different domains such as commuting, leisure‐time, and occupational PA . BP was assessed using the last 3 of 10 measurements after 10 minutes’ rest in the supine position. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or use of antihypertensives. In regression analysis, higher commuting and leisure‐time but not occupational MVPA related to lower BP and lower hypertension risk. Commuting‐and‐leisure‐time MVPA was associated with BP in a dose‐dependent manner. β Coefficients (95% CI ) from linear regression analyses were −1.64 (−2.03 to −1.24), −2.29 (−2.68 to −1.90), and finally −2.90 (−3.29 to −2.50) mm Hg systolic BP for the low, middle, and highest tertile of MVPA compared with “No MVPA ” as the reference group after adjusting for age, sex, education, smoking and alcohol use. Further adjustment for body mass index attenuated the associations by 30% to 50%, but more MVPA remained significantly associated with lower BP and lower risk of hypertension. This association was age dependent. β Coefficients (95% CI ) for the highest tertiles of commuting‐and‐leisure‐time MVPA were −1.67 (−2.20 to −1.15), −3.39 (−3.94 to −2.82) and −4.64 (−6.15 to −3.14) mm Hg systolic BP in adults <40, 40 to 60, and >60 years, respectively. Conclusions Higher commuting and leisure‐time but not occupational MVPA were significantly associated with lower BP and lower hypertension risk at all ages, but these associations were stronger in older adults.
Aims: To investigate prospectively the association of body fat percentage (BF%) estimates using various equations from bioelectrical impedance analysis (BIA) with cardiovascular events, compared with body mass index (BMI) and waist circumference. Methods and results: We used data of 34 BIA-BF%-equations that were used for estimation of BF% in 6486 (men ¼ 3194, women ¼ 3294) subjects. During a median follow-up of 8.3 years, 510 (7.9%) cardiovascular events (363 in men; 147 in women) occurred. In men, the crude hazard ratio (95% confidence interval) for BF% from the best predicting BIA-BF%-equation was 3.97 (3.30-4.78) against 2.13 (1.85-2.45) for BF% from the BIA device's BIA-BF%equation, 1.34 (1.20-1.49) for BMI and 1.49 (1.40-1.73) for waist circumference per log-1-SD increase of all. In women, the hazard ratios for best predicting BIA-BF%-equation, BIA device estimation, BMI and waist circumference were 3.80 (2.85-4.99), 1.89 (1.57-2.28), 1.35 (1.21-1.51) and 1.52 (1.31-1.75), respectively. After adjustments for age, Framingham cardiovascular disease risk score and creatinine excretion -a marker of muscle mass -BF%s and BMI remained independently associated with cardiovascular events in both men and women, while waist circumference was independently associated with cardiovascular events in men, but not in women. According to discrimination ability (C-index) and additive predictive value (net reclassification index and integrated discrimination index) on obesity measures to the Framingham cardiovascular disease risk score, BF% was superior to BMI and waist circumference in both men and women. Conclusions: BF% was independently associated with future cardiovascular events. Body fat estimates from the bestpredicting BIA-BF%-equations can be a more predictive measurement in cardiovascular risk assessment than BMI or waist circumference.
Specific author contributions: Oyuntugs Byambasukh analyzed the data, designed the study's analytic strategy, and interpreted the results. Dorien Zelle contributed to the hypothesis and edited the manuscript. Eva Corpeleijn planned and designed the study, analyzed the data, directed its implementation, and reviewed the manuscript.
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