Clustering of cardiovascular risk factors and physical inactivity: A dose-response analysis among adults in Tirana, Albania

Background: Cardiovascular risk factors rarely occur alone, and many adults in Southeastern Europe live with several of them. This study aimed to assess the dose-response association between cumulative cardiovascular risk-factor burden and physical inactivity among adults in Tirana, Albania. Methods: In this cross-sectional study, the first 250 consecutive adults were interviewed using the Global Physical Activity Questionnaire. Of these, 244 had complete data and were included in the analysis. Participants accumulating fewer than 600 metabolic equivalent (MET)-minutes per week were classified as inactive. Current smoking, overweight or obesity, hypertension, diabetes mellitus and hypercholesterolaemia were combined into a score (0–5), categorised as low (0–1), moderate (2–3) or high (≥4) burden. The association with inactivity was analysed using logistic regression adjusted for age and sex. Results: In total, 32.8% of participants were inactive and 58.2% had two or more risk factors. Inactivity rose stepwise across burden groups (24.5%, 36.7% and 45.5%; p for trend = .013). Compared with the low-burden group, the adjusted odds of inactivity were about twice as high in the moderate-burden group (odds ratio [OR] = 2.18; 95% confidence interval [CI] 1.10–4.31) and three times as high in the high-burden group (OR = 3.25; 95% CI 1.25–8.44), and each additional risk factor was associated with 31% higher odds. Conclusion: In our study, physical inactivity became more frequent as cardiovascular risk factors accumulated. Assessing risk factors jointly may help identify adults who most need support to become active.