Diurnal patterns of sedentary time in rheumatoid arthritis: associations with cardiovascular disease risk

Abstract

ObjectivesResearch demonstrates that sedentary behaviour may contribute towards cardiovascular disease (CVD) risk in rheumatoid arthritis (RA). This study explored diurnal patterns of sedentary time and physical activity (PA) in RA and examined associations with long-term CVD risk.Methods97 RA patients wore an accelerometer for 7 days to assess sedentary time, light-intensity and moderate-to-vigorous-intensity PA. Estimated 10-year CVD risk was determined via QRISK score. Hourly estimates of sedentary time and PA (min/hour) were computed for valid-wear hours (ie, valid-wear = 60 min/hour of activity data, ≥3 days). Hourly data were averaged across time periods to represent morning (08:00–11:59), afternoon (12:00–17:59) and evening (18:00–22:59) behaviour. Participants providing data for ≥2 complete time periods/day (eg, morning/evening, or morning/afternoon) were used in the main analysis (n = 41). Mixed linear modelling explored the associations between 10-year CVD risk and within-person (time: morning, afternoon, evening) changes in sedentary time and PA.ResultsSedentary time was higher, and light-intensity and moderate-to-vigorous-intensity PA lower in the evening, compared to morning and afternoon. Significant interactions revealed individuals with higher CVD risk were more sedentary and did less light-intensity PA during the afternoon and evening. Findings remained significant after adjustment for disease duration, functional ability and erythrocyte sedimentation rate.ConclusionResults suggest that the evening time period may offer a significant window of opportunity for interventions to reduce sedentary behaviour in RA and contribute to associated improvements in CVD risk. Due to inverse patterns of engagement, replacing sedentary time with light-intensity PA may offer an effective approach for intervention.

The behavioural epidemiology of sedentary behaviour in inflammatory arthritis: where are we, and where do we need to go?

“…The findings of Pinto et al [ 43 ] provide the first evidence that replacing sedentary time with periods of light physical activity (and ‘moving more’) might produce meaningful changes in important inflammatory arthritis outcomes. This research also aligns with the body of evidence to suggest that sedentary time might play a particularly important role in CVD risk for this population [ 15 , 31 , 44 ].…”

Physical activity, exercise and rheumatoid arthritis: Effectiveness, mechanisms and implementation

“…Moreover, randomized and controlled clinical trials consistently demonstrate significant reductions of radiological damage in small and large joints, as a result of increased levels of physical activity participation (11)(12)(13)(14), as well as reduced CVD risk and beneficial body composition changes that can reverse rheumatoid cachexia (14)(15)(16)(17). It is important to note that, increasing physical activity or engaging in different types of exercise, even in high-intensity exercise, is safe in RA with no studies reporting any adverse effects (18); in contrast, a sedentary lifestyle in RA can further promote the increased risk for future development of CVD (19)(20)(21). Despite this well-described cumulative evidence about its beneficial effects, methods to improve physical activity levels in patients with RA are not incorporated in routine clinical care.…”

Day-of-the-Week and Time-of-the-Day Patterns of Sedentary Behavior in the Hispanic Community Health Study/Study of Latinos

“…The clinical relevance of the temporal patterns of sedentary behavior is still emerging. Temporal patterns of sedentary behavior metrics over the course of the day (i.e., diurnal profile) have been associated with glycemic indices, CVD risk, and longitudinal declines in physical function in some populations (12,37,38). For example, in a sample of 37 adults with type 2 diabetes (38), breaks in sedentary time during evening hours were associated with better glycemic indices compared with breaks occurring during the morning or afternoon.…”