Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity

Abstract

BackgroundRheumatoid Arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD). The physical dysfunction symptomatic of RA means people living with this disease spend large periods of the day sedentary, which may further elevate their risk of CVD. The primary aim of this study was to investigate relationships between objectively assessed sedentary behaviour patterns and light physical activity (LPA) with 10-year risk of CVD. Secondary aims were to explore the role of sedentary behaviour patterns and LPA for individual CVD risk factors and functional disability in RA. The extent to which associations were independent of moderate-to-vigorous physical activity (MVPA) engagement was also examined.MethodsBaseline data from a subsample of participants recruited to the Physical Activity in Rheumatoid Arthritis (PARA) study were used to answer current research questions. Sixty-one patients with RA (mean age (± SD) = 54.92 ± 12.39 years) provided a fasted blood sample and underwent physical assessments to evaluate factors associated with their cardiovascular health. Sedentary behaviour patterns (sedentary time, sedentary bouts, sedentary breaks), LPA and MVPA were measured via 7-days of accelerometry. Ten-year CVD risk was computed (Q-risk-score2), and functional disability determined via questionnaire.ResultsRegressions revealed significant positive associations between sedentary time and the number of sedentary bouts per day ≥20 min with 10-year CVD risk, with the reverse true for LPA participation. Associations were independent of MVPA engagement.ConclusionsPromoting LPA participation and restricting sedentary bouts to <20 min may attenuate long-term CVD risk in RA, independent of MVPA engagement.Trial registration ISRCTN04121489 (retrospectively registered 19/10/2012).

Factors associated with physical activity engagement among adults with rheumatoid arthritis: A cross‐sectional study

“…PA level was significantly associated with lower functional disability and pain but not with any other RA disease symptoms. These findings conflict with previous data which suggested that there is no significant association between objectively assessed activity levels and functional disability (Fenton et al, ). Further studies are required to determine conclusively the interaction between PA and health outcomes among RA patients.…”

Correlates of sedentary behaviour and light physical activity in people living with rheumatoid arthritis: protocol for a longitudinal study

“…Findings revealed a positive relationship between sedentary time accumulated in bouts ≥20 minutes and 10-year CVD risk. This finding 37 is aligned with novel prospective and experimental studies, which indicate that shorter sedentary bouts (i.e., the duration of uninterrupted sedentary periods) and more frequent sedentary breaks (i.e., interruptions in sedentary time)with light physical activity (LPA [1.6 -<3 METS]), are beneficially linked to health outcomes in non-clinical and clinical populations. 20,27,[38][39][40][41][42][43] For example, regularly breaking up SB with LPA has been associated with better cardiometabolic and cardiovascular health in adults (≥20 years) 20,38 and older adults, 27 and has also been linked with a reduced risk of disability among older adults.…”

“…More recently, research studies have indicated that higher levels of accelerometer-assessed SB are associated with more pain and fatigue, 36 and a higher risk of CVD. 37 Specifically, Fenton et al 37 found that total sedentary time was adversely associated with 10-year CVD risk in a sample of RA patients. Interestingly, this study was the first to examine whether the manner in which sedentary time was accumulated held implications for health outcomes in RA.…”

Sitting time is negatively related to microvascular endothelium-dependent function in rheumatoid arthritis

“…This cross-sectional association was observed after adjusting for global CVD risk, RA characteristics and vasoactive medication. Results provide new evidence to suggest "too much sitting" may be linked to poorer endothelial function, and contribute toward increased CVD risk in RA [1,3].…”

“…Cardiovascular disease (CVD) 1 is the leading cause of death among people living with Rheumatoid Arthritis (RA) [1], with RA increasing CVD risk by ~50% compared to the general population [2]. High levels of sedentary behaviour (waking behaviour ≤1.5 metabolic equivalents, whilst sitting/lying) are linked to increased CVD risk in RA, independently of the benefits of physical activity [3]. Whilst the biological mechanisms underlying this adverse relationship are not yet known, recent experimental work suggests endothelial dysfunction may play an important role [4].…”