Key result
Long-term moderate physical activity is linked to ~23% lower CVD risk over 3 decades.
Why the study?
Does consistently maintaining guideline-recommended physical activity reduce incident cardiovascular disease in adults?
Cohort (n=225,264)
Yes
Does consistently maintaining guideline-recommended physical activity reduce incident cardiovascular disease in adults?
Hazard Ratio: 0.77 (95% CI 0.72–0.84)
Consistently maintaining moderate physical activity (around 11.6 MET-hours/week) over three decades is sufficient to achieve optimal cardiovascular risk reduction, with no additional benefit seen at higher levels.
Background: The long-term consistency of meeting physical activity guidelines may be critical for cardiovascular health, yet its independent contribution beyond total physical activity amount remains unclear. Methods: A total of 225,264 adults from 3 large prospective cohorts (Health Professionals Follow-up Study, 1988-16; Nurses’ Health Study, 1988-2018; Nurses’ Health Study II, 1991-2017) were included. Leisure-time physical activity was assessed biennially using validated questionnaires and expressed in metabolic equivalent (MET)-hours per week. Consistency was defined as the percentage of follow-up years meeting the recommended level (≥7.5 MET-hours/week) and was updated at each questionnaire cycle across three decades of follow-up. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cardiovascular disease (CVD), myocardial infarction (MI), and stroke. Results: Over up to 30 years of follow-up, 24,766 CVD cases were documented. In traditional dose–response analyses, the lowest CVD risk was observed at 50.7 MET-hours/week (HR = 0.73; 95% CI, 0.70–0.77). After considering long-term consistency, consistently maintaining the guideline-recommended level at moderate intensity (median = 11.6 MET-hours/week) was associated with a 23% lower CVD risk (HR = 0.77; 95% CI, 0.72–0.84) compared with individuals with low activity (<7.5 MET-hours/week) and very low consistency. Consistently maintaining higher levels of physical activity was not associated with additional risk reduction (HRs [95% CIs]: 0.78 [0.73–0.83], 0.80 [0.75–0.85], 0.77 [0.73–0.82], and 0.77 [0.73–0.82] for median levels of 18.7, 26.0, 36.3, and 60.7 MET-hours/week, respectively). Similar associations were observed for MI and stroke and were consistent after adjustment for body mass index and across subgroups defined by age, gender, smoking status, and dietary quality. Conclusions: Traditional dose-response analysis suggested that 50.7 MET-hours/week was needed for optimal mortality benefit. After incorporating long-term consistency, we found that maintaining a moderate level around 11.6 MET-hours/week over three decades was sufficient to achieve the optimal benefit in CVD risk reduction.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2026) conducted a cohort in Cardiovascular disease (n=225,264). Consistently maintaining guideline-recommended physical activity (median 11.6 MET-hours/week) vs. Low activity (<7.5 MET-hours/week) and very low consistency was evaluated on Incident cardiovascular disease (CVD) (HR 0.77, 95% CI 0.72-0.84). Consistently maintaining moderate physical activity (~11.6 MET-hours/week) over 3 decades was associated with a 23% lower risk of incident CVD compared with low activity (HR 0.77; 95% CI 0.72-0.84).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: