Association between daily steps with CVD risk among participants with mental distress: a prospective cohort study
M Li, C Zhu, Y Ou, Y LiangAbstract
Background
Mental distress is an independent risk factor for cardiovascular diseases (CVD), and daily steps can reduce incidental CVD risk. However, it remains unclear whether daily steps can alleviate the risk of CVD among participants with mental distress.
Objective
This study aims to investigate the association between daily steps, mental distress, and examine whether emotional distress and related pathways moderate the association.
Methods
74,583 participants (mean age=61.9, 44.6% male) were included. Daily steps were measured by 7-day accelerometer, and emotional distress was assessed using PHQ-4 scale. Incident CKD was ascertained through hospital records and death registries. Apoe⁻/⁻ mice underwent chronic restraint stress and exercise to assess how stress moderated exercise effects on atherosclerosis.
Results
Over median follow-up of 6.9 years, 8,017 incident CVD events occurred. Daily step counts and cadence exhibited inverse dose-response association with 10%-23% risk reduction of CVD. The optimal total step counts and purposeful steps were 10,000 and 5,000 steps per day, respectively. Emotional distress significantly modified daily steps-CVD association (Pinteraction<0.05). Steps’ benefit on CVD risk was greater among participants with emotional distress than those without (total step counts: HR = 0.76 vs 0.84; purposeful steps: HR= 0.75 vs 0.83; peak 30-min cadence: HR= 0.73 vs 0.85). Moreover, exercise reduced atherosclerotic progression among Apoe⁻/⁻ mice with chronic restraint stress by sympathetic activity and stress-related factors.
Conclusion
Higher daily step counts and cadence measured by accelerometer are associated with lower risk of CVD, particularly among individuals with emotional distress, potentially through stress-related process.
Acknowledgments
This research was conducted using the UK Biobank Resource under application number 58082. We sincerely thank the participants and staff who contributed to the UK Biobank.figure 1figure 2