Association between knee osteoarthritis and the risk of cardiovascular disease and the synergistic adverse effects of lack of exercise

Abstract

We aimed to determine whether knee OA is associated with CVD risk and all-cause death and to evaluate whether the association differs by exercise behavior. We used Korea National Health Insurance Service (KNHIS) database and included 201,466 participants (7572 subjects diagnosed with knee OA) who underwent health screening between 2009 and 2015. Those who had been diagnosed with knee OA or CVD before the index year were excluded. Cox proportional hazard models were used after adjusting for sociodemographic and CVD risk factors to evaluate the association between knee OA and CVD risk and all-cause death. Stratification analysis was further performed to determine the effect of exercise behavior on this relationship. During a median follow-up of 7.06 ± 2.24 years, 8743 CVD (2510 MI and 6553 stroke) cases developed. Individuals with knee OA had increased risks of CVD [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.15–1.38], myocardial infarction (MI) (HR 1.20, 95% CI 1.00–1.44), and stroke (HR 1.29, 95% CI 1.16–1.43) compared with those without knee OA. Those with knee OA who did not exercise had an increased risk of CVD (HR 1.25, 95% CI 1.11–1.40), whereas no significant increased CVD risk was observed in those with knee OA who exercised at least once a week (HR 1.11, 95% CI 0.96–1.28). There was no association between knee osteoarthritis and all-cause death. Knee OA was independently associated with an increased risk of CVD. Lack of exercise might have a synergistic adverse effect on the association between knee OA and CVD.

Association of Life's Essential 8 with osteoarthritis in United States adults: mediating effects of dietary intake of live microbes

“…Epidemiological studies have recognized healthy physical activity to be a key factor in the prevention and management of CVD and OA. A study also reported that 20–30 min of exercise performed once a week had a preventive effect on OA, especially in young patients with knee OA ( 25 ). Notably, insomnia and shorter sleep duration have an adverse impact on the risk of OA ( 21 ).…”

Impact of a Semi-Rigid Knee Orthotic Intervention on Pain, Physical Activity, and Functional Capacity in Patients with Medial Knee Osteoarthritis

“…An inadequate level of physical activity (PA) can result in excess bodyweight and, consequently, lead to higher mechanical joint loading and an acceleration in the degenerative process of KOA [ 4 , 9 ]. Furthermore, individuals with KOA are more prone to cardiovascular disease (CVD), and exercise is recommended for preventing such a disease [ 10 ]. The shared pathophysiological pathways and risk factors between CVD and KOA, such as age, hypertension, diabetes, and obesity, suggest an association between the two diseases, as indicated in a recent study by Park, Park, Ko, Choi, Min, Ahn, Kim, Koh, and Han [ 10 ], which investigated a large database (Korea National Health Insurance data).…”

“…Furthermore, individuals with KOA are more prone to cardiovascular disease (CVD), and exercise is recommended for preventing such a disease [ 10 ]. The shared pathophysiological pathways and risk factors between CVD and KOA, such as age, hypertension, diabetes, and obesity, suggest an association between the two diseases, as indicated in a recent study by Park, Park, Ko, Choi, Min, Ahn, Kim, Koh, and Han [ 10 ], which investigated a large database (Korea National Health Insurance data). Reduced PA [ 11 ] and muscle weakness [ 12 ], prevalent in KOA patients, are also correlated with elevated CVD risk [ 10 ].…”

Association of single nucleotide polymorphisms in ITLN1 gene with ischemic stroke risk in Xi’an population, Shaanxi province

“…In China, it is a leading cause of mortality. The occurrence of stroke is associated with various risk factors, including age, gender, overweight, smoking, hypertension, diabetes, diet, lack of exercise and psychological factors ( Christensen & Cordonnier, 2021 ; Drozdz et al, 2021 ; Harshfield et al, 2021 ; Park et al, 2023 ; Rexrode et al, 2022 ; Sun et al, 2022 ; Yang et al, 2022 ; Zhang et al, 2021 ). Notably, the improvement of people’s living standards has led to changes in diet and lifestyle, resulting in a decrease in the incidence of hemorrhagic stroke.…”