TY - JOUR
T1 - Joint associations of peripheral artery disease and accelerometry-based physical activity with mortality
T2 - The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
AU - Gao, Yumin
AU - Hua, Simin
AU - Mok, Yejin
AU - Salameh, Maya
AU - Qi, Qibin
AU - Chen, Guochong
AU - Williams-Nguyen, Jessica
AU - Pester, Mollie
AU - Garcia-Bedoya, Olga
AU - Sotres-Alvarez, Daniela
AU - Daviglus, Martha L.
AU - Mossavar-Rahmani, Yasmin
AU - Schrack, Jennifer A.
AU - Allison, Matthew
AU - Kaplan, Robert
AU - Matsushita, Kunihiro
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/4
Y1 - 2022/4
N2 - Background and aims: Peripheral artery disease (PAD) and lower levels of physical activity are both associated with higher mortality. Yet, their joint prognostic impact has not been systematically examined, especially in Hispanics/Latinos, and with objective measures. We aimed to examine the joint associations of PAD and physical activity with mortality in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: We studied 7,620 Hispanic/Latino adults aged 45–74 years at baseline (2008–2011) who underwent assessment of PAD with ankle-brachial index (ABI) and physical activity with hip-worn accelerometry. We calculated four physical activity measures: sedentary time, light activity, moderate/vigorous activity, and total activity counts. We quantified the relationship between ABI and mortality overall, and by tertiles of activity measures in restricted cubic splines, using multivariable Cox models accounting for sampling weights. We also assessed cross-categories of ABI and activity measures with mortality. Results: During a median follow up of 7.1 years, 314 participants died. We observed a U-shaped association of ABI with mortality overall (e.g., hazard ratio 1.80 [95%CI 1.20–2.80] at ABI 0.7 vs 1.2). This U-shaped association was generally consistent after stratifying by activity measures, but an elevated mortality risk for higher ABI was not evident in the most active tertile based on sedentary time, time in light activity, and total activity counts. In the cross-category analysis of ABI and physical activity, the highest mortality risk was consistently seen in abnormal ABI (≤0.9 or >1.4) plus the least active tertile (e.g., HR 5.61 [3.31–9.51] for light activity), compared to referent ABI (0.9–1.4) plus the other more active two tertiles, with no interactions between ABI and activity measure. Conclusions: Abnormal ABI and lower accelerometry-based physical activity were independently and jointly associated with mortality in Hispanics, suggesting the importance of simultaneously evaluating leg vascular condition and physical activity.
AB - Background and aims: Peripheral artery disease (PAD) and lower levels of physical activity are both associated with higher mortality. Yet, their joint prognostic impact has not been systematically examined, especially in Hispanics/Latinos, and with objective measures. We aimed to examine the joint associations of PAD and physical activity with mortality in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: We studied 7,620 Hispanic/Latino adults aged 45–74 years at baseline (2008–2011) who underwent assessment of PAD with ankle-brachial index (ABI) and physical activity with hip-worn accelerometry. We calculated four physical activity measures: sedentary time, light activity, moderate/vigorous activity, and total activity counts. We quantified the relationship between ABI and mortality overall, and by tertiles of activity measures in restricted cubic splines, using multivariable Cox models accounting for sampling weights. We also assessed cross-categories of ABI and activity measures with mortality. Results: During a median follow up of 7.1 years, 314 participants died. We observed a U-shaped association of ABI with mortality overall (e.g., hazard ratio 1.80 [95%CI 1.20–2.80] at ABI 0.7 vs 1.2). This U-shaped association was generally consistent after stratifying by activity measures, but an elevated mortality risk for higher ABI was not evident in the most active tertile based on sedentary time, time in light activity, and total activity counts. In the cross-category analysis of ABI and physical activity, the highest mortality risk was consistently seen in abnormal ABI (≤0.9 or >1.4) plus the least active tertile (e.g., HR 5.61 [3.31–9.51] for light activity), compared to referent ABI (0.9–1.4) plus the other more active two tertiles, with no interactions between ABI and activity measure. Conclusions: Abnormal ABI and lower accelerometry-based physical activity were independently and jointly associated with mortality in Hispanics, suggesting the importance of simultaneously evaluating leg vascular condition and physical activity.
KW - Accelerometer
KW - Cardiovascular disease
KW - Peripheral artery disease
KW - Physical activity
KW - Study of Latinos
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UR - http://www.scopus.com/inward/citedby.url?scp=85126688810&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2022.03.008
DO - 10.1016/j.atherosclerosis.2022.03.008
M3 - Article
C2 - 35334347
AN - SCOPUS:85126688810
SN - 0021-9150
VL - 347
SP - 55
EP - 62
JO - Atherosclerosis
JF - Atherosclerosis
ER -