The association of metabolic clustering and physical activity with cardiovascular mortality: the HUNT study in Norway

Tjønna, Arnt Erik; Nilsen, Tom Ivar Lund; Slørdahl, Stig A.; Vatten, Lars J.; Wisløff, Ulrik

doi:10.1136/jech.2008.084467

Cited by 24 publications

(16 citation statements)

References 34 publications

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“…Among participants with ≥2 metabolic risk factors at baseline, those who reported engaging in moderate‐to‐vigorous physical activity ≥3 times per week had an HR for CVD mortality of 0.63 (95% CI, 0.40–0.99) compared with those who reported none. Similar findings have been reported in a few other cohort studies for physical activity23, 24, 25 as well as for physical fitness 26. In a meta‐analysis examining cardiorespiratory fitness as a predictor of all‐cause mortality and CHD/CVD, results from 8 cohort studies indicated that each MET higher level of maximal aerobic capacity correlated with an 11% (95% CI, 7%–15%) lower risk of CHD/CVD among individuals with >3 metabolic factors 26…”

Section: Discussionsupporting

confidence: 82%

Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Chomistek

Cook

Rimm

et al. 2018

JAHA

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BackgroundThe inverse association between physical activity and cardiovascular disease (CVD) is well‐ established and has previously been shown in people with and without single CVD risk factors. We examined whether level of global cardiovascular risk, on the basis of the pooled cohort equation or Reynolds risk score, which include multiple risk factors, modified the physical activity–CVD association.Methods and ResultsParticipants in the prospective WHS (Women's Health Study; n=27 536) reported their leisure‐time physical activity at study entry (1992–1995) and during follow‐up through 2013. Participants were divided into 10‐year cardiovascular risk groups on the basis of the pooled cohort equation and Reynolds risk score. The primary outcome was incident total CVD. The CVD hazard ratio for active (≥500 kcal/wk of physical activity) compared with inactive (<500 kcal/wk) individuals was 0.73 (95% confidence interval, 0.66–0.80) in multivariable models. This association was not modified by level of cardiovascular risk; physical activity was inversely associated with CVD within all pooled cohort equation and Reynolds risk score groups (P=0.17 and P=0.66 for interaction, respectively). When the joint association of physical activity and level of cardiovascular risk was examined, women with higher risk on the basis of either the pooled cohort equation or Reynolds risk score had higher CVD rates compared with those at low risk, regardless of physical activity. However, among women at both high and low risk, being physically active was associated with lower risk of CVD events.ConclusionsIn this large prospective cohort of women, level of global cardiovascular risk did not modify the inverse association between leisure‐time physical activity and incident CVD. Thus, promoting physical activity is important in women at both low and high cardiovascular risk.

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Section: Discussionsupporting

confidence: 82%

Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Chomistek

Cook

Rimm

et al. 2018

JAHA

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“…It has previously been shown that mortality from CVD is higher in subjects with the metabolic syndrome [23], and that this association is stronger in women than in men [13], [23]. It has also been suggested that hyperglycemia per se, more than the metabolic syndrome as an entity, predicts the prognosis and outcome in CVD [7], [18], [24], [25], [26], and that young women are especially prone to the negative effects of both [27].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

et al. 2014

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BackgroundSeveral studies suggest that cardiovascular risk factors comprising the metabolic syndrome have larger effects on the development of cardiovascular disease in women than in men. A recent study in self-reported healthy subjects demonstrated a marked gender difference in endothelial dysfunction that may be an important precursor of manifest cardiovascular disease. The aim of the present study was to determine whether the association between endothelial function and cardiovascular risk factors is different in self-reported healthy women compared to self-reported healthy men.Methods and ResultsAssociations between endothelial function (flow mediated dilation, FMD, of the brachial artery measured by ultrasound), anthropometric variables, peak oxygen uptake (VO2peak), blood pressure, serum lipids, blood glucose and a questionnaire on general health and lifestyle including smoking status were studied by logistic and linear regression in 2 528 women and 2 211 men aged 20–89 years, free from self-reported cardiovascular disease. In women with hyperglycemia, endothelial dysfunction (FMD ≤0%) occurred twice as frequently as in male counterparts. The presence of the metabolic syndrome, high blood pressure and low VO2peak increased the prevalence of endothelial dysfunction more in women than in men.ConclusionEndothelial dysfunction is more strongly associated with cardiovascular risk factors in self-reported healthy women than in self-reported healthy men. This finding could explain why the metabolic syndrome, and especially hyperglycemia, is associated with higher cardiovascular risk and a worse prognosis in women.

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“…A summary score below the median was classified as low activity, whereas a score at the median or above was classified as high activity. This summary score has been used in previous studies from the same population; both in relation to risk of cancer23 and mortality from CVDs associated with metabolic clustering 24. The properties of an approximately similar measure of exercise volume were assessed in a validation of the PA questions and found to perform well 22…”

Section: Methodsmentioning

confidence: 99%

Combined effect of resting heart rate and physical activity on ischaemic heart disease: mortality follow-up in a population study (the HUNT study, Norway)

Nauman

Nilsen

Wisløff

et al. 2010

Journal of Epidemiology & Community Health

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The association of metabolic clustering and physical activity with cardiovascular mortality: the HUNT study in Norway

Abstract: These data show that individuals with CRF are at greater risk of premature cardiovascular death compared to people without CRF, and that the risk of people with CRF who were physically active appears to be comparable to that of inactive individuals without CRF.

Cited by 24 publications

References 34 publications

Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Physical Activity and Incident Cardiovascular Disease in Women: Is the Relation Modified by Level of Global Cardiovascular Risk?

Cardiovascular Risk Factors Have Larger Impact on Endothelial Function in Self-Reported Healthy Women than Men in the HUNT3 Fitness Study

Combined effect of resting heart rate and physical activity on ischaemic heart disease: mortality follow-up in a population study (the HUNT study, Norway)

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