Association of Accelerometer‐Derived Physical Activity with Incident Cardiovascular Diseases and Mortality in People With Severe Mental Illness

Background Cardiovascular vascular disease (CVD) is a leading cause of increased mortality in people with severe mental illness (SMI). This study aims to examine the dose–response and intensity‐specific associations between physical activity (PA) and CVD risk and mortality in people with SMI. Methods This prospective cohort study was conducted on 6313 participants with SMI with accelerometry data from UK Biobank from February 2013 to November 2021. Moderate‐to‐vigorous PA (MVPA) was categorized into 2 groups (<150 and ≥150 min/week) according to the PA guidelines for adults recommended by the World Health Organization, while total PA and light‐intensity PA were grouped by tertiles. Incident CVD, all‐cause and CVD mortality ascertained by hospital and death registries were primary outcomes. Results Among 6313 participants (mean age 61.05 years; 33.9% men), 868 developed incident CVD, 233 died from any cause, and 88 died from CVD during a median follow‐up of 7 years. PA was inversely associated with the risk of incident CVD, all‐cause mortality, and CVD mortality. Performing guideline‐recommended MVPA was associated with 18% reduced risk for incident CVD (95% CI, 0.68–0.99), 42% for all‐cause mortality (95% CI, 0.43–0.79), and 49% for CVD mortality (95% CI, 0.31–0.83). A combination of recommended MVPA and moderate light‐intensity PA was associated with the lowest risk, with risk reductions of 24%, 59%, and 78%, respectively. Conclusions Adequate PA, especially guideline‐recommended MVPA, was associated with a lower risk for incident CVD, all‐cause and CVD mortality among SMI population. Combining recommended MVPA with moderate light‐intensity PA yielded extra benefits.