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Joint associations of peripheral artery disease and accelerometry-based physical activity with mortality: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

TitleJoint associations of peripheral artery disease and accelerometry-based physical activity with mortality: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Publication TypePublication
Year2022
AuthorsGao Y, Hua S, Mok Y, Salameh M, Qi Q, Chen G, Williams-Nguyen J, Pester M, Garcia-Bedoya O, Sotres-Alvarez D, Daviglus ML, Mossavar-Rahmani Y, Schrack JA, Allison M, Kaplan R, Matsushita K
JournalAtherosclerosis
Volume347
Pagination55-62
Date Published2022 04
ISSN1879-1484
KeywordsAccelerometry, ankle brachial index, exercise, Hispanic or Latino, Humans, Peripheral Arterial Disease, Public Health, Risk Factors
Abstract

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.

DOI10.1016/j.atherosclerosis.2022.03.008
Alternate JournalAtherosclerosis
PubMed ID35334347
PubMed Central IDPMC9014557
Grant ListHHSN268201300005C / HL / NHLBI NIH HHS / United States
HHSN268201300004C / HL / NHLBI NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
HHSN268201300003C / HG / NHGRI NIH HHS / United States
R01 HL146132 / HL / NHLBI NIH HHS / United States
HHSN268201300001C / HL / NHLBI NIH HHS / United States
MS#: 
0908
Manuscript Lead/Corresponding Author Affiliation: 
Ancillary Study Investigators - Not at HCHS/SOL site
ECI: 
Manuscript Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
Manuscript Status: 
Published