Key result
High leisure-time physical activity linked to ~50% lower sudden cardiac death risk vs low activity.
Why the study?
Sudden cardiac death remains a major public health challenge, yet the long-term association of leisure-time physical activity with SCD risk is not well established.
Does moderate or high leisure-time physical activity reduce sudden cardiac death in adult residents?
Cohort (n=10,100)
No
Does moderate or high leisure-time physical activity reduce sudden cardiac death in adult residents?
Higher leisure-time physical activity is associated with a significantly lower long-term risk of sudden cardiac death, with low activity accounting for up to 33% of SCD events.
Answers are grounded in this paper and cite their sources.
May support promoting higher leisure-time activity to lower SCD risk; leaves open causality in this observational cohort.
Background: Sudden cardiac death (SCD) remains a major public health challenge, yet the long-term association of leisure-time physical activity with SCD risk is not well established. We examined whether self-reported leisure-time physical activity is associated with SCD incidence over 28 years, accounting for competing risks from non-SCD mortality and time-updated changes in leisure-time physical activity. Methods: We included 10,100 participants from the Copenhagen City Heart Study, examined in 1991-1994 and followed until 31 December 2021. SCD events were identified from Danish death certificates using a standardized protocol. Leisure-time physical activity was self-reported at baseline and at 10-year follow-up and incorporated as a time-updated exposure, categorized as low, moderate, or high. Cause-specific Cox models estimated associations with SCD, adjusting for age, sex, smoking, alcohol, and socioeconomic factors. Cumulative incidence was standardized to the Danish population, and population attributable risk for low activity was calculated. This study is registered at ClinicalTrials.gov (NCT02993172). Findings: During a median follow-up of 28.6 years, 897 SCD events occurred among 10,100 participants (mean age 60.8 years; 56% women). Twenty-year standardized cumulative incidence rose with lower activity. In time-updated analyses, moderate and high leisure-time physical activity were associated with lower SCD risk compared with low activity (hazard ratio (HR) of 0.60, 95% confidence interval (CI) 0.50-0.72; and HR 0.50, 95% CI 0.41-0.62, respectively). After 25 years, 33% (95% CI 21-46%) of SCD could be attributed to low activity. Interpretation: Higher leisure-time physical activity is associated with lower long-term risk of SCD in this observational cohort. These findings support the potential public health relevance of promoting leisure-time physical activity, although causality cannot be established.
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Isozaki et al. (2026) conducted a cohort in Risk of sudden cardiac death (n=10,100). High leisure-time physical activity vs. Low leisure-time physical activity was evaluated on Sudden cardiac death (SCD) incidence (HR 0.50, 95% CI 0.41-0.62, p=<0.001). High leisure-time physical activity was associated with a 50% lower long-term risk of sudden cardiac death compared with low activity.
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