Associations of between- and within-day patterns of physical activity accumulation with arterial stiffness and indices of microvascular health-Evidence from The Maastricht study

While physical activity (PA) is understood to promote vascular health, little is known about whether the daily and weekly patterns of PA accumulation associate with vascular health. Accelerometer-derived (activPAL3) 6- or 7-day stepping was analyzed for 6430 participants in The Maastricht Study (50.4% women; 22.4% Type 2 diabetes mellitus (T2DM)). Multivariable regression models examined associations between stepping metrics (average step count, and time spent slower and faster paced stepping) with arterial stiffness (measured as carotid-femoral pulse wave velocity (cfPWV)), and several indices of microvascular health (heat-induced skin hyperemia, retinal vessel reactivity and diameter), adjusting for confounders and moderators. PA pattern metrics were added to the regression models to identify associations with vascular health beyond that of stepping metrics. Analyses were stratified by T2DM status if an interaction effect was present. Average step count and time spent faster paced stepping was associated with better vascular health, and the association was stronger in those with compared to those without T2DM. In fully adjusted models a higher step count inter-daily stability was associated with a higher (worse) cfPWV in those without T2DM (std β = 0.04, p = 0.007) and retinal venular diameter in the whole cohort (std β = 0.07, p = 0.002). A higher within-day variability in faster paced stepping was associated with a lower (worse) heat-induced skin hyperemia in those with T2DM (std β = -0.31, p = 0.008). Above and beyond PA volume, the daily and weekly patterns in which PA was accumulated were additionally associated with improved macro- and microvascular health, which may have implications for the prevention of vascular disease.

Association of the Amount and Pattern of Physical Activity With Arterial Stiffness: The Maastricht Study

We examined the associations of the amount and the pattern of higher intensity physical activity with arterial stiffness. Data from The Maastricht Study (n=1699; mean age: 60±8 years, 49.4% women, 26.9% type 2 diabetes (T2DM)) were used. Arterial stiffness was assessed by carotid-to-femoral pulse wave velocity (cfPWV). The amount (hours/day) and pattern of higher intensity physical activity were assessed with the activPAL3®. Activity groups were: inactive (<75min/week), insufficiently active (75-150min/week), weekend warrior (>150min/week in ≤2 sessions), and regularly active (>150min/week in ≥3 sessions). After full adjustment, higher intensity physical activity was associated with lower cfPWV (amount: -0.35[-0.65;-0.05], insufficiently active: -0.33[-0.55;-0.11]; weekend warrior: -0.38[-0.64;-0.12] and regularly active: -0.46[-0.71;-0.21] (reference: inactive)). These associations were stronger in those with T2DM. Participating in higher intensity physical activity was associated with lower cfPWV, regardless of the weekly pattern, and may be an important strategy to reduce CVD risk, particularly in T2DM.