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Weekend Warrior Physical Activity and Risk of Cardiovascular Disease
Quick Takes
- World Health Organization and American Heart Association guidelines recommend ≥150 minutes of moderate to vigorous physical activity (MVPA) per week, although the optimal MVPA pattern is unspecified.
- A weekend warrior pattern may be a reasonable strategy to encourage patients to achieve MVPA target goals to lower cardiovascular risks.
- MVPA ≥150 minutes per week, regardless of the pattern performed within a week, may improve the cardiovascular risk of AF, MI, HF, and stroke.
Study Questions:
Can moderate to vigorous physical activity (MVPA) performed by a weekend warrior (WW) over 1-2 days provide similar cardiovascular benefits compared to MVPA distributed more evenly within a week?
Methods:
A retrospective analysis of UK Biobank participants underwent 1 week of wristed-based accelerometer MVPA measurement for various physical activities (e.g., walking, jogging, cycling) between 2013–2015 to compare the cardiovascular risks of three activity patterns: active WW (≥150 minutes with ≥50% of total MVPA in 1-2 days), active regular (≥150 minutes but over >2 days), and inactive (<150 total minutes). Cox proportional hazard regressions were used to assess the association between the patterns and incident atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF), and stroke. The association of the three patterns to the actual median threshold of ≥230.4 minutes of MVPA per week was also assessed to determine the performance level of MVPA for cardiovascular benefits.
Results:
The study followed 89,573 participants (mean [SD] age, 62 [7.8] years; 56% women) for a median 6.3 years. Multivariable-adjusted models found that both the active WW (42.2%) and active regular (24.0%) groups were associated with similar lower risks of incident AF (active WW: hazard ratio [HR], 0.78 [95% CI, 0.74-0.83]; active regular: 0.81 [95% CI, 0.74-0.88; inactive: HR, 1.00 [95% CI, 0.94-1.07]), MI (active WW: 0.73 [95% CI, 0.67-0.80]; active regular: 0.65 [95% CI, 0.57-0.74]; and inactive: 1.00 [95% CI, 0.91-1.10]), HF (active WW: 0.62 [95% CI, 0.56-0.68]; active regular: 0.64 [95% CI, 0.56-0.73]; and inactive: 1.00 [95% CI, 0.92-1.09]), and stroke (active WW: 0.79 [95% CI, 0.71-0.88]; active regular: 0.83 [95% CI, 0.72-0.97]; and inactive: 1.00 [95% CI, 0.90-1.11]).
Both active WW and active regular groups had similar lower risks for AF, MI, and HF at the guideline-based ≥150 minutes and the study median threshold of ≥230.4 minutes of MVPA per week. The association for lower stroke risk was significant when <230.4 minutes of MVPA per week (active WW: 0.89 [95% CI, 0.79-1.02]; active regular: 0.87 [95% CI, 0.74-1.02]; and inactive: 1.00 [95% CI, 0.90-1.11]).
Conclusions:
A WW pattern of physical activity is associated with similar protection for cardiovascular risks of AF, MI, HF, and stroke compared with more evenly distributed physical activity.
Perspective:
A WW pattern is common (42.2%) and may be a more feasible strategy, and less discouraging, for a patient’s lifestyle in order to achieve guideline-based MVPA recommendations for cardiovascular health. This study found that MVPA concentrated within 1-2 days was associated with similar cardiovascular outcomes when compared to MVPA distributed more evenly within the week.
Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Sports and Exercise Cardiology, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Exercise
Keywords: Accelerometry, Atrial Fibrillation, Bicycling, Cardiovascular Diseases, Exercise, Heart Failure, Jogging, Life Style, Myocardial Infarction, Primary Prevention, Risk Factors, Sedentary Behavior, Stroke, Walking
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