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. 2024 Aug 31;65(2):E134-E144.
doi: 10.15167/2421-4248/jpmh2024.65.2.3243. eCollection 2024 Jun.

Longitudinal trends in physical activity levels and lifetime cardiovascular disease risk: insights from the ATTICA cohort study (2002-2022)

Nikos Dimitriadis  1 , Thomas Tsiampalis  1   2   3 , Giannis Arnaoutis  1 , Konstantinos D Tambalis  4 , Evangelia Damigou  1 , Christina Chrysohoou  5 , Fotios Barkas  6 , Costas Tsioufis  5 , Christos Pitsavos  5 , Evangelos Liberopoulos  7 , Petros P Sfikakis  7 , Demosthenes Panagiotakos  1   3
Affiliations

Longitudinal trends in physical activity levels and lifetime cardiovascular disease risk: insights from the ATTICA cohort study (2002-2022)

Nikos Dimitriadis et al. J Prev Med Hyg. .

Abstract

Objective: To evaluate trends in physical activity levels and their associations with demographic characteristics, health status, and lifetime cardiovascular disease (CVD) risk.

Methods: A longitudinal analysis was conducted using data from 987 males and 1,001 females (45 ± 12 years old) participating in the ATTICA cohort study. Physical activity levels were assessed at baseline (2001-2002) and subsequent follow-ups (2006, 2012, and 2022). Four physical activity trajectories according to participants' physical activity tracking were defined, i.e., consistently active/inactive and changed from active/inactive. Twenty-year incidence of hypertension, hypercholesterolemia, and diabetes were evaluated in relation to physical activity trajectories; the life-table method was utilized to forecast the lifetime CVD risk (death without CVD was regarded as a competing event).

Results: in total, 47% of the participants were categorized as being consistently inactive, whereas only 9% of males and 15% of females sustained physical activity levels throughout the 20-year follow-up period (p < 0.001). Participants being consistently inactive were from lower socioeconomic backgrounds (p = 0.002). Transitioning to being physically active was associated with higher education level and being married (p < 0.001). Consistently active individuals had up to 35% reduced lifetime CVD risk, and lower 20-year incidence of hypertension, and hypercholesterolemia (p < 0.01); no association was observed regarding diabetes incidence.

Conclusions: Promoting and maintaining regular physical activity throughout lifespan is crucial for reducing lifetime CVD risk and related risk factors. Tailored interventions addressing demographic and socioeconomic factors may help enhance cardiovascular health outcomes.

Keywords: ATTICA study; Lifetime CVD risk; Physical activity trajectories; Socio-economic determinants.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Distribution of physical activity status at each time-point, by sex and age group of the participants; ATTICA study (2002-2022).
Fig. 2.
Fig. 2.
Heatmap presenting the time trajectories of physical activity status in males and females, stratified by their socioeconomic status and age at baseline; ATTICA study (2002-2022).
See this image and copyright information in PMC

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