Key result
Long-term high occupational physical activity is linked to higher LVESV and ~2% lower LVEF.
Why the study?
Occupational physical activity may have paradoxically negative cardiovascular health associations, prompting testing of the hypothesis that chronic occupational strain leads to unfavourable cardiac remodelling.
Does high occupational physical activity affect left ventricular structure and function over 25 years in young adults?
Cohort (n=1,462)
Does high occupational physical activity affect left ventricular structure and function over 25 years in young adults?
Effect estimate: LVESVi β=1.84; LVEF β=-1.94
p-value: p=<0.05
High occupational physical activity over 25 years is associated with mildly adverse left ventricular remodeling, including higher end-systolic volume and lower ejection fraction, supporting the 'physical activity paradox'.
Should not alter activity recommendations; extends observational support for the physical activity paradox.
Aims Leisure time physical activity (LTPA) confers cardiovascular health benefits, while occupational physical activity (OPA) may have paradoxically negative health associations. This study tested the explanatory hypothesis that unfavourable cardiac remodelling may result from chronic OPA-induced cardiovascular strain. Methods and results Longitudinal associations of OPA and left ventricular (LV) structure and function were examined in 1462 participants {50.0% female, 56.4% White, aged 30.4 ± 3.4 years at baseline [Year 5 exam (1990–91)]} from the Coronary Artery Risk Development in Young Adults study. Left ventricular structure and function were measured as LV mass (LVMi), end-diastolic volume (LVEDVi), end-systolic volume (LVESVi), ejection fraction (LVEF), stroke volume (LVSVi), and e/a-wave ratio (EA ratio) via echocardiography at baseline and 25 years later. Occupational physical activity was reported at seven exams during the study period as months/year with ‘vigorous job activities such as lifting, carrying, or digging’ for ≥5 h/week. The 25-year OPA patterns were categorized into three trajectories: no OPA (n = 770), medium OPA (n = 410), and high OPA (n = 282). Linear regression estimated associations between OPA trajectories and echocardiogram variables at follow-up after adjusting for baseline values, individual demographic/health characteristics, and LTPA. Twenty-five-year OPA exposure was not significantly associated with LVMi, LVEDVi, LVSVi, or EA ratio (P > 0.05). However, higher LVESVi (β = 1.84, P < 0.05) and lower LVEF (β = −1.94, P < 0.05) were observed at follow-up among those in the high- vs. no-OPA trajectories. Conclusion The paradoxically adverse association of OPA with cardiovascular health was partially supported by null or adverse associations between high OPA and echocardiogram outcomes. Confirmation is needed using more precise OPA measures.
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Quinn et al. (2023) conducted a cohort in Cardiovascular health (n=1,462). Occupational physical activity (OPA) vs. No occupational physical activity was evaluated on Left ventricular structure and function (LVMi, LVEDVi, LVESVi, LVEF, LVSVi, and EA ratio) (LVESVi β=1.84; LVEF β=-1.94, p=<0.05). High occupational physical activity over 25 years was associated with higher left ventricular end-systolic volume (β=1.84, P<0.05) and lower ejection fraction (β=-1.94, P<0.05) compared to no OPA.
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