Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study

Valenzuela, Pedro L.; Santos‐Lozano, Alejandro; Torres–Barrán, Alberto; Fernández-Navarro, Pablo; Castillo‐García, Adrián; Ruilope, Luis; Insua, David Rı́os; Ordovás, José M.; Ley, Victoria; Lucı́a, Alejandro

doi:10.1093/eurjpc/zwaa151

Cited by 28 publications

(17 citation statements)

References 10 publications

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“…These results are consistent with our results. [34][35][36] Generally, obesity is a recognized and important predictor of morbidity and mortality of patients with CVD and other diseases (including chronic nephropathy and chronic obstructive pulmonary disease). 37,38 However, some studies have reported that obesity is related to reduced mortality in patients with HF.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Prognostic Nutrition Index and New York Heart Association Classification in Patients with Coronary Heart Disease: A RCSCD-TCM Study

Ma¹,

Liu²,

Liu³

et al. 2022

JIR

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This study aimed to elucidate the relationship between the prognostic nutrition index (PNI) of patients with coronary heart disease (CHD) and the New York Heart Association (NYHA) classification and the complex relationship between PNI combined body mass index (BMI) and NYHA classification. Methods: The PNI was applied to 17,413 consecutive patients with CHD. Patients were divided into three groups according to PNI: normal nutrition (PNI ≥ 38), moderate malnutrition (35 < PNI < 38), and severe malnutrition (PNI ≤ 35). A total of 2,052 CHD patients with BMI were selected and stratified by combined subgroups of nutritional status and BMI. Logistic regression analysis was used to evaluate the relationship between the PNI and NYHA classification and to adjust for confounding factors. Results:The prevalence of malnutrition among the 17,413participants with CHD was 4.2%. Moderate and severe malnutrition were significantly related to NYHA class III and V, and the strongest relationship was observed in NYHA class V (odd ratio [OR]: 6.564; 95% confidence interval [CI]: 4.043-10.658). Malnourished-underweight patients and malnourished-overweight patients were significantly associated with higher NYHA classification, and malnourished-underweight patients (OR: 8.038; 95% CI: 2.091-30.892) were significantly more than malnourished-overweight patients (OR: 3.580; 95% CI: 1.286-9.966). Conclusion: There were differences in the NYHA classification of CHD patients with different nutritional statuses. The lower the PNI, the worse the NYHA classification of CHD patients. Malnourished-underweight patients had a worse NYHA classification than malnourished-overweight patients.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Prognostic Nutrition Index and New York Heart Association Classification in Patients with Coronary Heart Disease: A RCSCD-TCM Study

Ma¹,

Liu²,

Liu³

et al. 2022

JIR

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“…44 Our findings also showed that obese participants had significantly lower levels of physical activity than those with normal weight: increasing physical activity level may thus be a practical method to reduce CVD risk in those with overweight or obesity, at a stage when metabolic disorders have not occurred yet. 45 Moreover, MUO status at an early stage produced more detrimental effects than MHO status on CAC progression and subsequent CVD events in later midlife.…”

Section: Discussionmentioning

confidence: 99%

Different Metabolic Phenotypes of Obesity and Risk of Coronary Artery Calcium Progression and Incident Cardiovascular Disease Events: The CARDIA Study

Gao

You

Liu

et al. 2022

ATVB

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Background: To investigate whether obesity with or without metabolic syndrome is prospectively associated with coronary artery calcium (CAC) progression and incident cardiovascular disease events. Methods: A total of 1730 participants from the CARDIA study (Coronary Artery Risk Development in Young Adults) were included (age, 40.1±3.6 years; 38.3% men), who completed computed tomography of CAC at baseline (year 15: 2000–2001) and follow-up (year 20 or 25). Metabolically healthy obesity (MHO) was defined as body mass index≥30 kg/m 2 without any metabolic syndrome components in our main analysis. Sensitivity analyses were conducted for several conditions characterizing 4 metabolic phenotypes. Results: During a mean follow-up of 9.1 years, 439 participants had CAC progression. MHO subjects had a significantly higher risk of CAC progression than their metabolically healthy normal weight counterparts (adjusted hazard ratios [95% CIs] from 1.761 [1.369–2.264] to 2.047 [1.380–3.036]) depending on the definition of MHO adopted. Obesity with unhealthy metabolic profile remained the highest significant risk of CAC progression and cardiovascular disease events whatever the definitions adopted for metabolically unhealthy status. Up to 60% of participants with MHO converted to metabolically unhealthy obesity from year 15 to year 20 or year 25. Further sensitivity analysis showed that MHO throughout carried a similar risk of incident cardiovascular disease events compared with metabolically healthy normal weight throughout. Conclusions: Different metabolic phenotypes of obesity beginning at a young age exhibit distinct risks of CAC progression and subsequent cardiovascular disease events in later midlife. MHO represents an intermediate phenotype between metabolically low- to high-risk obese individuals. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00005130.

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“…e ., medicated against hypertension or presenting a systolic/diastolic office blood pressure ≥140/90 mmHg) 26 . Physical inactivity was determined from self‐reported leisure‐time physical activity levels, assessed as explained elsewhere 27 . Briefly, participants filled a questionnaire about the frequency and intensity of physical activity during a typical week.…”

Section: Methodsmentioning

confidence: 99%

“…26 Physical inactivity was determined from self-reported leisure-time physical activity levels, assessed as explained elsewhere. 27 Briefly, participants filled a questionnaire about the frequency and intensity of physical activity during a typical week. They were considered 'inactive' if they did not meet minimum World Health Organization recommendations for aerobic physical activity (i.e., <150 and <75 min per week in moderate and vigorous aerobic activities, respectively).…”

Section: Variablesmentioning

confidence: 99%

Poor self‐reported sleep is associated with risk factors for cardiovascular disease: A cross‐sectional analysis in half a million adults

Santos‐Lozano

Torres–Barrán

Morales

et al. 2022

Eur J Clin Investigation

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Background Sleep is known to affect cardiovascular health, but some controversy exists on the independent association between different sleep characteristics (duration, restfulness, difficulties falling asleep) and specific risk factors for cardiovascular disease (CVD). We aimed to assess the association between self‐reported sleep characteristics and the likelihood of major CVD risk factors. Methods Totally, 521,364 Spanish workers (32% female, 44 ± 9 years [18–64]) insured by an occupational risk prevention company participated in this nationwide cross‐sectional study. Participants’ sleep was considered ‘poor’ if they reported having ≥1 of the following conditions: excessively short (<6 h/d) or long (>9 h/d) sleep, unrestful sleep, or difficulties to fall asleep. We assessed the independent association between aforementioned sleep characteristics and the prevalence of hypertension, diabetes, hypercholesterolaemia, obesity and physical inactivity. Results Poor sleep (reported by 33% of participants) was associated with a higher likelihood of presenting all CVD risk factors individually, particularly physical inactivity (which prevalence was ~3‐fold higher in the poor sleep group compared with participants reporting no sleep abnormality). In separate analyses, all the different sleep characteristics were associated with the likelihood of ≥2 CVD risk factors. Participants with optimal sleep, normal sleep duration, no difficulties falling sleep and restful sleep showed a lower total CVD risk score than their peers with poor sleep, short sleep duration, difficulties falling sleep and unrestful sleep, respectively (all p < .001). Conclusions Poor sleep was associated with a higher likelihood of presenting major CVD risk factors. These findings might support the importance of monitoring and improving sleep patterns for primary CVD prevention.

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Joint association of physical activity and body mass index with cardiovascular risk: a nationwide population-based cross-sectional study

Cited by 28 publications

References 10 publications

Relationship Between Prognostic Nutrition Index and New York Heart Association Classification in Patients with Coronary Heart Disease: A RCSCD-TCM Study

Relationship Between Prognostic Nutrition Index and New York Heart Association Classification in Patients with Coronary Heart Disease: A RCSCD-TCM Study

Different Metabolic Phenotypes of Obesity and Risk of Coronary Artery Calcium Progression and Incident Cardiovascular Disease Events: The CARDIA Study

Poor self‐reported sleep is associated with risk factors for cardiovascular disease: A cross‐sectional analysis in half a million adults

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