Leisure-time physical activity does not boost CV risk prediction performance
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Adding leisure-time physical activity level did not improve the risk prediction performance of the American Heart Association/American College of Cardiology Pooled Cohort equations, researchers reported.
“The addition of self-reported leisure-time physical activity (LTPA) levels to Pooled Cohort Equations does not appear to be associated with improvement in risk prediction model performance,” Ambarish Pandey, MD, MSCS, assistant professor of internal medicine at University of Texas Southwestern Medical Center, and colleagues wrote.
The researchers analyzed 18,824 participants (mean age, 58 years; 54.7% women).
The researchers found that 31.2% of the participants were inactive, 20.4% had less than guideline-recommended LTPA, 17.9% had guideline-recommended LTPA and 30.5% had greater than guideline-recommended LTPA level.
According to the researchers, higher levels of self-reported LTPA were associated with lower atherosclerotic CVD risk when adjusted for age, sex and race/ethnicity (HR per 1 standard deviation higher LTPA = 0.87; 95% CI, 0.82-0.92) and for traditional CVD risk factors (HR per 1 standard deviation higher LTPA = 0.91; 95% CI, 0.86-0.96).
According to the researchers, the risk prediction model C statistics among the groups were 0.768 (95% CI, 0.75- 0.788) for the inactive group; 0.771 (95% CI, 0.75-0.792) for the less than guideline-recommended group; 0.763 (95% CI, 0.738-0.788) for the guideline-recommended group; and 0.761 (95% CI, 0.742-0.78) for the more than guideline-recommended group.
Adding self-reported LTPA levels to the original Pooled Cohort Equations did not alter the C statistic (0.0005; 95% CI, 0.0004 to 0.0015; P = .28) and the categorical net reclassification index (0.003; 95%; CI, 0.01 to 0.01; P = .95) in the overall cohort. However, it resulted in minimal integrated discrimination index improvement (0.0008; 95% CI, 0.0002-0.0013; P = .005), the researchers wrote.
“These observations regarding the performance of Pooled Cohort Equations in the context of LTPA do not diminish the importance of physical activity as a core principle for promoting cardiovascular wellness,” the researchers wrote.
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