Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences

Emmanuel Stamatakis; Matthew Ahmadi; Raaj Kishore Biswas; Borja Del Pozo Cruz; Cecilie Thøgersen-Ntoumani; Marie H Murphy; Angelo Sabag; Scott Lear; Clara Chow; Jason M R Gill; Mark Hamer

doi:10.1136/bjsports-2024-108484

Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences

Br J Sports Med. 2024 Dec 28:bjsports-2024-108484. doi: 10.1136/bjsports-2024-108484. Online ahead of print.

Authors

Emmanuel Stamatakis^{1

2}, Matthew Ahmadi^{3

2}, Raaj Kishore Biswas^{3

2}, Borja Del Pozo Cruz^{4

5

6}, Cecilie Thøgersen-Ntoumani⁷, Marie H Murphy⁸, Angelo Sabag², Scott Lear⁹, Clara Chow¹⁰, Jason M R Gill¹¹, Mark Hamer¹²

Affiliations

¹ Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia emmanuel.stamatakis@sydney.edu.au.
² School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
³ Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
⁴ Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain.
⁵ Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain.
⁶ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁷ Danish Centre for Motivation and Behaviour Science, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Syddanmark, Denmark.
⁸ Physical Activity for Health Research Centre, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK.
⁹ Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
¹⁰ Westmead Applied Research Centre, University of Sydney and Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia.
¹¹ School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
¹² Institute of Sport Exercise and Health, Division Surgery Interventional Science, University College London, London, London, UK.

PMID: 39467622
DOI: 10.1136/bjsports-2024-108484

Abstract

Background: Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of intense physical activity embedded into daily life.

Objective: To examine sex differences in the dose-response association of VILPA with major adverse cardiovascular events (MACE) and its subtypes.

Methods: Using multivariable-adjusted cubic splines, we examined the associations of daily VILPA duration with overall MACE and its subtypes (incident myocardial infarction, heart failure and stroke) among non-exercisers (individuals self-reporting no leisure-time exercise and no more than one recreational walk per week) in the UK Biobank. We also undertook analogous analyses for vigorous physical activity among exercisers (individuals self-reporting participation in leisure-time exercise and/or recreational walking more than once a week).

Results: Among 13 018 women and 9350 men, there were 331 and 488 all MACE, respectively, over a 7.9-year follow-up. In women, daily VILPA duration exhibited a near-linear dose-response association with all MACE, myocardial infarction and heart failure. In men, dose-reponse curves were less clear with less evidence of statistical signifigance. Compared with women with no VILPA, women's median daily VILPA duration of 3.4 min was associated with hazard ratios (HRs; 95% confidence intervals) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Women's minimum doses of 1.2-1.6 min of VILPA per day were associated with HRs of 0.70 (0.58 to 0.86) for all MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. The equivalent analyses in UK Biobank's accelerometry sub-study exercisers suggested no appreciable sex differences in dose-response.

Conclusions: Among non-exercising women, small amounts of VILPA were associated with a substantially lower risk of all MACE, myocardial infarction and heart failure. VILPA may be a promising physical activity target for cardiovascular disease prevention, particularly in women unable or not willing to engage in formal exercise.

Keywords: Cardiovascular Diseases; Cohort Studies; Exercise; Heart disease; Physical activity.