• Kelsie M Full, Kara M Whitaker, Pettee GabrielKelleyKDepartment of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, United States of America., Cora E Lewis, Barbara Sternfeld, Stephen Sidney, Jared P Reis, David R Jacobs, GibbsBethany BaroneBBDepartment of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, United States of America., and Pamela J Schreiner.
• Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States of America. Electronic address: fullx003@umn.edu.
• Prev Med. 2021 Sep 1; 150: 106626.

AbstractCardiovascular risk and functional burden, or the accumulation of cardiovascular risk factors coupled with functional decline, may be an important risk state analogy to multimorbidity. We investigated prospective associations of sedentary time (ST), light intensity physical activity (LPA), and moderate to vigorous intensity physical activity (MVPA) with cardiovascular risk and functional burden at midlife. Participants were 1648 adults (mean ± SD age = 45 ± 4 years, 61% female, 39% Black) from Coronary Artery Risk Development in Young Adults (CARDIA) who wore accelerometers in 2005-2006 and 2015-2016. Cardiovascular risk and functional burden was defined as ≥2 cardiovascular risk factors (untreated/uncontrolled hypertension and hypercholesterolemia, type 2 diabetes, reduced kidney function) and/or functional decline conditions (reduced physical functioning and depressive symptoms). Prospective logistic regression models tested single activity, partition, and isotemporal substitution associations of accelerometer-measured ST, LPA, and MVPA with cardiovascular risk and functional burden 10 years later. In isotemporal models of baseline activity, reallocating 24 min of ST to MVPA was associated with 15% lower odds of cardiovascular risk and functional burden (OR: 0.85; CI: 0.75, 0.96). Reallocating 24 min of LPA to MVPA was associated with a 14% lower odds of cardiovascular risk and functional burden (OR: 0.86; CI: 0.75, 0.99). In longitudinal isotemporal models, similar beneficial associations were observed when 10-year increases in MVPA replaced time in ST or LPA. Findings suggest that maintaining an MVPA dose reflecting daily physical activity recommendations in early midlife is associated with lower odds of cardiovascular risk and functional burden later in midlife.Copyright © 2021 Elsevier Inc. All rights reserved.

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