University of Oulu

Niemelä M, Kiviniemi A, Ikäheimo TM, et al. Compositional association of 24-h movement behavior with incident major adverse cardiac events and all-cause mortality. Scand J Med Sci Sports. 2023;33:641-650. doi:10.1111/sms.14315

Compositional association of 24-h movement behavior with incident major adverse cardiac events and all-cause mortality

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Author: Niemelä, Maisa1,2,3; Kiviniemi, Antti2,4; Ikäheimo, Tiina M.5,6;
Organizations: 1Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
2Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
3Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
4Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
5Department of Community Medicine, University of Tromso, Tromso, Norway
6Research Unit of Population Health, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: John Wiley & Sons, 2023
Publish Date: 2023-08-14


Cardiovascular disease (CVD) causes a high disease burden. Physical activity (PA) reduces CVD morbidity and mortality. We aimed to determine the relationship between the composition of moderate-to-vigorous PA (MVPA), light PA (LPA), sedentary behavior (SB), and sleep during midlife to the incidence of major adverse cardiac events (MACE) and all-cause mortality at a 7-year follow-up. The study population consisted of Northern Finland Birth Cohort 1966 members who participated in the 46-year follow-up in 2012 and were free of MACE (N = 4147). Time spent in MVPA, LPA, and SB was determined from accelerometer data. Sleep time was self-reported. Hospital visits and deaths were obtained from national registers. Participants were followed until December 31, 2019, or first MACE occurrence (acute myocardial infarction, unstable angina pectoris, stroke, hospitalization due to heart failure, or death due to CVD), death from another cause, or censoring. Cox proportional hazards model was used to estimate hazard ratios of MACE incidence and all-cause mortality. Isotemporal time reallocations were used to demonstrate the dose–response association between time spent in behaviors and outcome. The 24-h time composition was significantly associated with incident MACE and all-cause mortality. More time in MVPA relative to other behaviors was associated with a lower risk of events. Isotemporal time reallocations indicated that the greatest risk reduction occurred when MVPA replaced sleep. Higher MVPA associates with a reduced risk of incident MACE and all-cause mortality after accounting for the 24-h movement composition and confounders. Regular engagement in MVPA should be encouraged in midlife.

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Series: Scandinavian journal of medicine & science in sports
ISSN: 0905-7188
ISSN-E: 1600-0838
ISSN-L: 0905-7188
Volume: 33
Issue: 5
Pages: 641 - 650
DOI: 10.1111/sms.14315
Type of Publication: A1 Journal article – refereed
Field of Science: 315 Sport and fitness sciences
Funding: NFBC1966 received financial support from University of Oulu Grant no. 65354, Oulu University Hospital Grant no. 2/97, 8/97, Ministry of Health and Social Affairs Grant no. 23/251/97, 160/97, 190/97, National Institute for Health and Welfare, Helsinki Grant no. 54121, Regional Institute of Occupational Health, Oulu, Finland Grant no. 50621, 54231. The study was supported by the Ministry of Education and Culture (grant numbers OKM/54/626/2019, OKM/85/626/2019, OKM/1096/626/2020, OKM/20/626/2022). The study is also connected to the DigiHealth-project, a strategic profiling project at the University of Oulu, which is supported by the Academy of Finland (project number 326291) and the University of Oulu.
Dataset Reference: Research data are not shared.
Copyright information: © 2023 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.