Stamatakis Emmanuel, Ahmadi Matthew, Biswas Raaj Kishore, Del Pozo Cruz Borja, Thøgersen-Ntoumani Cecilie, Murphy Marie H, Sabag Angelo, Lear Scott, Chow Clara, Gill Jason M R, Hamer Mark
Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Br J Sports Med. 2025 Feb 20;59(5):316-324. doi: 10.1136/bjsports-2024-108484.
Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of intense physical activity embedded into daily life.
To examine sex differences in the dose-response association of VILPA with major adverse cardiovascular events (MACE) and its subtypes.
Using multivariable-adjusted cubic splines, we examined the associations of daily VILPA duration with overall MACE and its subtypes (incident myocardial infarction, heart failure and stroke) among non-exercisers (individuals self-reporting no leisure-time exercise and no more than one recreational walk per week) in the UK Biobank. We also undertook analogous analyses for vigorous physical activity among exercisers (individuals self-reporting participation in leisure-time exercise and/or recreational walking more than once a week).
Among 13 018 women and 9350 men, there were 331 and 488 all MACE, respectively, over a 7.9-year follow-up. In women, daily VILPA duration exhibited a near-linear dose-response association with all MACE, myocardial infarction and heart failure. In men, dose-reponse curves were less clear with less evidence of statistical signifigance. Compared with women with no VILPA, women's median daily VILPA duration of 3.4 min was associated with hazard ratios (HRs; 95% confidence intervals) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Women's minimum doses of 1.2-1.6 min of VILPA per day were associated with HRs of 0.70 (0.58 to 0.86) for all MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. The equivalent analyses in UK Biobank's accelerometry sub-study exercisers suggested no appreciable sex differences in dose-response.
Among non-exercising women, small amounts of VILPA were associated with a substantially lower risk of all MACE, myocardial infarction and heart failure. VILPA may be a promising physical activity target for cardiovascular disease prevention, particularly in women unable or not willing to engage in formal exercise.
剧烈间歇性生活方式体力活动（VILPA）是指融入日常生活中的短暂高强度体力活动。
研究VILPA与主要不良心血管事件（MACE）及其亚型之间剂量反应关联的性别差异。
我们使用多变量调整的三次样条曲线，在英国生物银行中，研究了非运动者（自我报告无休闲时间运动且每周休闲散步不超过一次的个体）每日VILPA持续时间与总体MACE及其亚型（新发心肌梗死、心力衰竭和中风）之间的关联。我们还对运动者（自我报告每周参与休闲时间运动和/或休闲散步超过一次的个体）的剧烈体力活动进行了类似分析。
在13018名女性和9350名男性中，经过7.9年的随访，分别有331例和488例发生了所有MACE事件。在女性中，每日VILPA持续时间与所有MACE、心肌梗死和心力衰竭呈现近乎线性的剂量反应关联。在男性中，剂量反应曲线不太清晰，统计学显著性证据较少。与无VILPA的女性相比，女性每日VILPA持续时间中位数为3.4分钟时，所有MACE的风险比（HRs；95%置信区间）为0.55（0.41至0.75），心力衰竭的风险比为0.33（0.18至0.59）。女性每天VILPA最低剂量为1.2 - 1.6分钟时，所有MACE的HRs为0.70（0.58至0.86），心肌梗死的HRs为0.67（0.50至0.91），心力衰竭的HRs为0.60（0.45至0.81）。英国生物银行加速度计子研究中运动者的等效分析表明，剂量反应方面没有明显的性别差异。
在不运动的女性中，少量的VILPA与所有MACE、心肌梗死和心力衰竭的风险大幅降低相关。VILPA可能是预防心血管疾病的一个有前景的体力活动目标，特别是对于那些无法或不愿意进行正规运动的女性。
