{
  "abstract": "Objective Physical activity (PA) is generally cardioprotective, but the relationship between PA intensity and bout length and major adverse cardiovascular events (MACEs) in adults with hypertension remains unclear.Methods Participants of the UK Biobank wearables substudy with a clinical diagnosis of hypertension were included. Short bouts of moderate intensity PA were classified as lasting up to 3 min and for vigorous intensity up to 1 min. Long bouts of moderate intensity PA were classified as lasting >5 min and for vigorous intensity >2 min. MACEs were defined as the composite of cardiovascular disease mortality and incidence of stroke, myocardial infarction and heart failure. We used Cox proportional hazards regression and Fine-Gray subdistribution for MACE and subtype analyses.Results During an average follow-up of 7.9 (±1.1) years among 38 960 participants (58.1% female; average age 62.1 (±7.7) years), there were 1416 MACE, including 397 stroke, 508 myocardial infarction and 363 heart failure events. Both short and long bouts of moderate intensity PA were associated with lower MACE risk, with subtype analyses showing longer bouts may enhance protective associations. For vigorous intensity PA, amounts accrued through short bouts exhibited a consistent association with lower MACE risk (HR=0.62 (95% CI 0.51 to 0.76) for 22 min/week), while amounts accrued through long bouts were associated with a higher risk of stroke, with a steep gradient of higher risk with longer durations (HR=2.06 (95% CI 1.38 to 3.07) for 44 min/week up to 2.80 (95% CI 1.72 to 4.56) for 64 min/week).Conclusions Short and long bouts of moderate intensity PA were associated with a lower risk of overall MACE, with evidence suggesting that longer bouts may enhance this protective association. For vigorous intensity PA, short bouts showed strong associations with lower overall MACE risk, while long bouts were associated with a 2–3 fold higher stroke risk, with a dose-response pattern evident across higher durations. Our results highlight the benefits and risks of PA bout length and intensity in adults with hypertension.",
  "authors": [
    {
      "affiliations": [
        "School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia",
        "Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia",
        "Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Matthew Ahmadi"
    },
    {
      "affiliations": [
        "School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Angelo Sabag"
    },
    {
      "affiliations": [
        "Snow Vision Accelerator, Save Sight Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Raaj Kishore Biswas"
    },
    {
      "affiliations": [
        "Department of Sport Sciences, Faculty of Medicine, Health, and Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain"
      ],
      "name": "Borja del Pozo Cruz"
    },
    {
      "affiliations": [
        "Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia",
        "Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia",
        "George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia",
        "Research Education Network, Western Sydney Local Health District, Sydney, New South Wales, Australia"
      ],
      "name": "Clara Chow"
    },
    {
      "affiliations": [
        "Cardiometabolic Medicine, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia",
        "Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"
      ],
      "name": "John O’Sullivan"
    },
    {
      "affiliations": [
        "Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, Netherlands"
      ],
      "name": "Thijs Eijsvogels"
    },
    {
      "affiliations": [
        "School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia",
        "Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia",
        "Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia"
      ],
      "name": "Emmanuel Stamatakis"
    }
  ],
  "title": "Impact of physical activity patterns on major adverse cardiovascular events in adults with hypertension",
  "uid": "21919962-6155-5b05-9e2a-1213b315b690"
}