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September 15, 2026BMC Public HealthOpen Access

Association of accelerometer measured moderate to vigorous physical activity and risks of recurrent cardiovascular disease and all-cause mortality

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Key result

Increased MVPA links to ~24% lower mortality but higher recurrent CVD risk in survivors.

  • HR 0.76
  • 95% CI 0.60-0.96
  • P=0.02
  • n=4,636

Why the study?

It remains unclear whether moderate and vigorous physical activities are associated differently with recurrent cardiovascular disease and mortality.

Does increased moderate to vigorous physical activity affect the risk of recurrent cardiovascular disease and all-cause mortality in cardiovascular disease survivors?

Population

4,636 cardiovascular disease survivors from the UK biobank

Comparison

Different levels or intensities of accelerometer-measured MVPA

Design

Cohort study

Follow-up

Average follow-up period of 9.16 years

Authors

FWFeifei WangLHLili HuangYCYue Chen

Discussion

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Overview

In cardiovascular disease survivors, increased moderate to vigorous physical activity was associated with lower all-cause mortality but paradoxically increased the risk of recurrent cardiovascular disease.

Key Points

  • To evaluate the association between accelerometer-measured moderate to vigorous physical activity and the risks of recurrent cardiovascular disease and all-cause mortality in cardiovascular disease survivors.
  • Analyzed data from 4,636 cardiovascular disease survivors (69.05% men, mean baseline age 60.73 [SD = 6.41] years) in the UK Biobank.
  • Measured weekly hours of moderate to vigorous physical activity using dominant-wrist accelerometers deployed between 2013 and 2016.
  • Tracked recurrent cardiovascular disease events and all-cause mortality over an average follow-up of 9.16 years (through March 31, 2024).
  • During follow-up, 721 deaths and 256 recurrent cardiovascular disease events were documented.
  • Higher intensity of moderate to vigorous physical activity was associated with a reduced risk of all-cause mortality (HR: 0.76; 95% CI: 0.60–0.96).
  • Higher intensity of moderate to vigorous physical activity was linked to an increased risk of recurrent cardiovascular disease (HR: 1.7; 95% CI: 1.07–2.7).

Study Design

Type

Cohort (n=4,636)

Multicenter

Yes

Structured PICO

Does increased moderate to vigorous physical activity affect the risk of recurrent cardiovascular disease and all-cause mortality in cardiovascular disease survivors?

P
Population
4,636 cardiovascular disease survivors aged 40 to 69 years from the UK Biobank, followed for an average of 9.16 years.
E
Exposure
Increased moderate to vigorous physical activity (MVPA) assessed by wrist-worn accelerometers
O
Outcome
Recurrent cardiovascular disease and all-cause mortalityhard clinical

Main Result

Hazard Ratio: 0.76 (95% CI 0.6–0.96)

p-value: p=0.02

In cardiovascular disease survivors, increased moderate to vigorous physical activity was associated with lower all-cause mortality but paradoxically increased the risk of recurrent cardiovascular disease.

Limitations

  • UK Biobank participants are healthier and live in less socio-economically deprived areas than the general population.
  • Unclear whether a 7-day physical activity assessment is representative of longer-term physical activity behaviors.
  • Residual or unmeasured confounders such as employment status, type of MVPA, and diet quality were not accounted for.
  • Did not involve dietary factors as covariates.
  • Lacks direct measures of cardiorespiratory fitness (CRF).
  • No information on resistance exercise frequency or volume.
  • Hand grip strength data were unavailable in the accelerometer subsample.

Cite This Study

Wang et al. (2026) conducted a cohort in Cardiovascular disease (n=4,636). Moderate to vigorous physical activity (MVPA) vs. Lowest quartile of MVPA was evaluated on All-cause mortality (HR 0.76, 95% CI 0.60-0.96, p=0.02). Increased moderate to vigorous physical activity was associated with a lower risk of all-cause mortality (HR 0.76) but a higher risk of recurrent cardiovascular disease (HR 1.7) in CVD survivors.

synapsesocial.com/papers/6aa9017deed42882c1fc196chttps://doi.org/10.1186/s12889-026-29367-w
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Dose-response association of an accelerometer-measured physical activity with all-cause mortality and cardiovascular disease incidence: Prospective cohort with 76,074 participants2024 · 11 citations
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  4. 4Associations of Combined Moderate and Vigorous Physical Activity With All‐Cause, Cardiovascular, and Cancer Mortality: A Cohort Study of 586 936 US Adults2026
  5. 5Revisiting the concept of bout: associations of moderate-to-vigorous physical activity sessions and non-sessions with mortality2024 · 11 citations