Fortuin-de Smidt, Melony CSewe, Maquins OdhiamboLassale, CamilleWeiderpass, ElisabeteAndersson, JonasHuerta, Jose MariaEkelund, UlfAleksandrova, KrasimiraTong, Tammy YnDahm, Christina CTjønneland, AnneKyrø, CecilieSteindorf, KarenSchulze, Matthias BKatzke, VerenaSacerdote, CarlottaAgnoli, ClaudiaMasala, GiovannaTumino, RosarioPanico, SalvatoreBoer, Jolanda MaOnland-Moret, N CharlotteWendel-Vos, Gc Wandavan der Schouw, Yvonne TBorch, Kristin BenjaminsenAgudo, AntonioPetrova, DafinaChirlaque, María DoloresConchi, Moreno IribasAmiano, PilarMelander, OlleHeath, Alicia KAune, DagfinnForouhi, Nita GLangenberg, ClaudiaBrage, SorenRiboli, ElioWareham, Nicholas JDanesh, JohnButterworth, Adam SWennberg, Patrik2023-05-032023-05-032022-03-10Fortuin-de Smidt MC, Sewe MO, Lassale C, Weiderpass E, Andersson J, Huerta JM, et al. Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study. Eur J Prev Cardiol. 2022 Sep 7;29(12):1618-1629.http://hdl.handle.net/10668/19773This study aimed to evaluate the association between physical activity and the incidence of coronary heart disease (CHD) in individuals with and without CHD risk factors. EPIC-CVD is a case-cohort study of 29 333 participants that included 13 582 incident CHD cases and a randomly selected sub-cohort nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Self-reported physical activity was summarized using the Cambridge physical activity index (inactive, moderately inactive, moderately active, and active). Participants were categorized into sub-groups based on the presence or the absence of the following risk factors: obesity (body mass index ≥30 kg/m2), hypercholesterolaemia (total cholesterol ≥6.2 mmol/L), history of diabetes, hypertension (self-reported or ≥140/90 mmHg), and current smoking. Prentice-weighted Cox regression was used to assess the association between physical activity and incident CHD events (non-fatal and fatal).Compared to inactive participants without the respective CHD risk factor (referent), excess CHD risk was highest in physically inactive and lowest in moderately active participants with CHD risk factors. Corresponding excess CHD risk estimates amongst those with obesity were 47% [95% confidence interval (CI) 32-64%] and 21% (95%CI 2-44%), with hypercholesterolaemia were 80% (95%CI 55-108%) and 48% (95%CI 22-81%), with hypertension were 80% (95%CI 65-96%) and 49% (95%CI 28-74%), with diabetes were 142% (95%CI 63-260%), and 100% (95%CI 32-204%), and amongst smokers were 152% (95%CI 122-186%) and 109% (95%CI 74-150%). In people with CHD risk factors, moderate physical activity, equivalent to 40 mins of walking per day, attenuates but does not completely offset CHD risk.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/Case-cohort studyCoronary heart diseasePhysical activityPopulation preventable fractionRisk factorsAdultCohort StudiesCoronary DiseaseExerciseHumansHypercholesterolemiaHypertensionIncidenceObesityProspective StudiesRisk Factorsresearch article35403197open accessEjercicio físicoEnfermedad coronariaEstudios prospectivosEstudios de cohortesFactores de riesgoHipercolesterolemiaHipertensiónHumanosIncidenciaObesidad10.1093/eurjpc/zwac0552047-4881https://academic.oup.com/eurjpc/advance-article-pdf/doi/10.1093/eurjpc/zwac055/43683452/zwac055.pdf