Sci Prog. 2026 Jul-Sep;109(3):368504261479121. doi: 10.1177/00368504261479121. Epub 2026 Aug 14.
ABSTRACT
ObjectiveThis study examined the separate and joint associations between modifiable behavioral risk factors (daily sitting time (DST), physical activity (PA) levels) and all-cause and premature mortality among individuals diagnosed with Cardiovascular Disease (CVD).MethodsThis retrospective cohort study analyzed data from 2,530 adult CVD patients in the National Health and Nutrition Examination Survey (2007-2018), and linked records to the National Death Index through December 31, 2019. Physical activity was categorized as high (≥500 MET-min/week) or low (<500 MET-min/week), while daily sitting time was classified as low (<7 hours/day) or high (≥7 hours/day). We used survey-weighted Cox regression, restricted cubic splines (RCS), and Kaplan-Meier survival analysis to evaluate relationships and conducted subgroup analyses to verify consistency.ResultsThe cohort had a weighted mean age of 59.12±0.27 years (56.61% men, 68.01% non-Hispanic White), with 531 all-cause mortality (374 premature deaths). PA≥500 MET-min/week was associated with lower all-cause (HR = 0.49, 95% CI:0.37-0.64) and premature mortality (HR=0.44, 95% CI:0.32-0.61); Each 1-SD increase in PA was linked to 52% and 51% lower risks of all-cause and premature mortality. DST≥7 hours/day increased all-cause (HR=1.67, 95% CI:1.32-2.11) and premature mortality (HR=1.74, 95% CI:1.30-2.32); Each 1-SD increase in DST was linked to 31% and 33% higher risks of all-cause and premature mortality. The lowest mortality risk was among those with DST <7 hours/day and PA ≥500 MET-min/week (all-cause: HR = 0.37; premature: HR = 0.31). RCS showed linear positive associations for DST (P for nonlinearity >0.05) and nonlinear negative associations for PA (P for nonlinearity < 0.05) with mortality; subgroup analyses confirmed stable associations.ConclusionsThis study suggests that increasing physical activity and reducing daily sitting time may be associated with lower risks of all-cause mortality and premature death in patients with CVD, with more favorable effects observed when the two behaviors are combined. Promoting a combination of higher PA and lower DST may be a useful reference of routine CVD risk management.
PMID:42600035 | DOI:10.1177/00368504261479121