Associations of Accelerometer‐Derived “Weekend Warrior” Physical Activity Pattern With Incident First Cardiometabolic Disease and Cardiometabolic Multimorbidity in Individuals With Hypertension

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Abstract
Background: To examine associations between accelerometer‐derived “weekend warrior” (WW) physical activity pattern (most moderate‐to‐vigorous‐intensity physical activity in 1–2 days) versus moderate‐to‐vigorous‐intensity physical activity spread more evenly with risks of incident first cardiometabolic disease (FCMD) and cardiometabolic multimorbidity (CMM) among hypertension participants. Methods: UK Biobank participants with hypertension (n=26891) provided a full‐week of accelerometer‐derived physical activity data between 2013 and 2015, processed using GGIR and a machine‐learning classifier. CMM was defined as the occurrence of at least 2 of type 2 diabetes, ischemic heart disease, and stroke. Three activity patterns (WW, regular, and inactive) were compared across multiple thresholds and definitions of active WW, with significance corrected for multiple comparisons at a false discovery rate of 0.05. Results: Over 7.5 years median follow‐up, 2718 individuals developed FCMD and 219 developed CMM. Using the definition of WW as guideline‐based and ≥50% of total moderate‐to‐vigorous‐intensity physical activity over 1 to 2 days via GGIR, we observed similarly lower risks of incident FCMD (WW versus inactive: hazard ratio [HR], 0.75 [95% CI, 0.69–0.82], P =1.4 × 10 −3 ; regular versus inactive: HR, 0.85 [95% CI, 0.74–0.96], P =2.6 × 10 −2 ) and CMM (WW versus inactive: HR, 0.59 [95% CI, 0.41–0.83], P =4.0 × 10 −3 ). Both active WW and regular physical activity patterns were associated with lower risk of FCMD compared with inactivity, with no statistically significant differences between the 2 active patterns. However, the result of WW versus inactive for CMM showed no statistical significance. Conclusions: Increased activity, even when concentrated within 1 to 2 days/week may reduce cardiometabolic disease risk in individuals with hypertension.

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