February 10, 2020
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Physical inactivity confers similar ASCVD risk to smoking status

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Jamal S. Rana

Physical inactivity was associated with an excess risk for atherosclerotic CVD similar to smoking and poor cholesterol levels, according to a research letter published in the European Journal of Preventive Cardiology.

“Motivating patients to get more physically active remains a major challenge,” Jamal S. Rana, MD, PhD, FACC, chief of cardiology at Kaiser Permanente Oakland Medical Center and adjunct researcher in the division of research at Kaiser Permanente in Oakland, California, told Healio. “These findings show that the discussion with our patients about the relative contributions of these important measures of health remains as urgent as ever.”

Researchers analyzed data from 991,698 patients (57% women) treated at Kaiser Permanente Northern California from 2013 to 2014 who did not have ASCVD. Several metrics from the American Heart Association CV health risk factors were assessed: physical activity, smoking, BP, BMI, blood glucose and total cholesterol.

The outcome of interest was ASCVD, defined as a composite of fatal CHD, nonfatal MI, and fatal or nonfatal stroke.

Compared with ideal levels of risk factors, patients with poor fasting glucose levels and BP had a twofold risk for ASCVD. The excess risk for ASCVD linked to poor physical activity was similar to current tobacco use status. The association between poor BMI and high ASCVD risk was not consistent compared with ideal BMI status after adjustment. The links between excess ASCVD risk and CV health metrics were similar across major racial/ethnic groups.

“In Kaiser Permanente, physical activity is measured as a ‘vital sign’ during patient encounters just like heart rate or blood pressure,” Rana said in an interview. “Such research hopefully is stimulus for other health systems to also adopt this practice, as this is a reminder to both patient and the treating physician.”

Stephen Sidney

Stephen Sidney, MD, MPH, director of research clinics for the division of research at Kaiser Permanente, commented on how physical activity can be improved in patients. “Improving physical activity needs to have the same public health approach as successful past interventions for smoking cessation and expanding use of cholesterol-lowering therapy,” he said. – by Darlene Dobkowski

For more information:

Jamal S. Rana, MD, PhD, FACC, can be reached at jamal.s.rana@kp.org.

Stephen Sidney, MD, MPH, can be reached at steve.sidney@kp.org.

Disclosures: The study was supported by the Kaiser Permanente Northern California Community Benefit Fund. The authors report no relevant financial disclosures.