Personal Activity Intelligence and Ischemic Heart Disease in a Healthy Population: China Kadoorie Biobank Study

Pål Hammer; Atefe R Tari; Barry A Franklin; Chi-Pang Wen; Ulrik Wisløff; Javaid Nauman

doi:10.3390/jcm11216552

Personal Activity Intelligence and Ischemic Heart Disease in a Healthy Population: China Kadoorie Biobank Study

J Clin Med. 2022 Nov 4;11(21):6552. doi: 10.3390/jcm11216552.

Authors

Pål Hammer¹, Atefe R Tari^{1

2

3}, Barry A Franklin^{3

4

5}, Chi-Pang Wen^{6

7}, Ulrik Wisløff^{1

3

8}, Javaid Nauman^{1

3

9}

Affiliations

¹ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
² Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway.
³ Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL 60612, USA.
⁴ Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI 48073, USA.
⁵ William Beaumont School of Medicine, Oakland University, Rochester, MI 48309, USA.
⁶ National Health Research Institute, Zhunan Town 35053, Taiwan.
⁷ Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung City 40447, Taiwan.
⁸ School of Human Movement and Nutrition Science, University of Queensland, St. Lucia, QLD 4072, Australia.
⁹ Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates.

Abstract

Background: Personal Activity Intelligence (PAI) is a physical activity metric that translates heart rate during physical activity into a simple score, where a weekly score of 100 or greater is associated with a lower risk of cardiovascular disease and mortality. Here, we prospectively investigated the association between PAI and ischemic heart disease (IHD) mortality in a large healthy population from China.

Methods: Using data from the China Kadoorie Biobank, we studied 443,792 healthy adults (60% women). The weekly PAI score of each participant was estimated based on the questionnaire data and divided into four groups (PAI scores of 0, ≤50, 51-99, or ≥100). Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for fatal IHD and nonfatal myocardial infraction (MI) related to PAI were estimated using Cox proportional hazard regression analyses.

Results: There were 3050 IHD deaths and 1808 MI events during a median follow-up of 8.2 years (interquartile range, 7.3-9.1; 3.6 million person-years). After adjustments for multiple confounders, a weekly PAI score ≥ 100 was associated with a lower risk of IHD (aHR: 0.91 (95% CI: 0.83-1.00)), compared with the inactive group (0 PAI). The corresponding aHR for MI was 0.94 (95% CI: 0.83-1.05). In participants aged 60 years or older at baseline, the aHR associated with a weekly PAI score ≥ 100 was 0.84 (95% CI, 0.75-0.93) for IHD and 0.84 (95% CI, 0.73-0.98) for MI.

Conclusion: Among healthy Chinese adults, a weekly PAI score of 100 or greater was associated with a lower risk of IHD mortality across all age groups; moreover, a high PAI score significantly lowered the risk of MI but only in those 60 years and older at baseline. The present findings extend the scientific evidence that PAI may have prognostic significance in diverse settings for IHD outcomes and suggest that the PAI metric may be useful in delineating the magnitude of weekly physical activity needed to reduce the risk of IHD mortality.

Keywords: Personal Activity Intelligence; activity metric; exercise; ischemic heart disease; myocardial infarction; physical activity.

Grants and funding

The work was supported by grants from the Norwegian Research Council and the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology (NTNU). The funding organizations had no role in the design and execution of the study, in the collection, analyses, or interpretation of the data. Further, they had no role in the preparation, review, or approval of the manuscript.