Physical activity reduces cardiovascular risk and mortality in people with severe mental illness: a cohort study using accelerometry.

Introduction: Cardiovascular disease (CVD) is a leading cause of excess mortality in people with severe mental illness (SMI). Physical activity (PA) is widely acknowledged with multiple health benefits, but associations of PA with incident CVD, all-cause and CVD mortality in people with SMI remain unclear. Objectives: To determine dose-response and intensity-specific associations of PA with incident CVD, all-cause and CVD mortality in people with SMI. Methods: This prospective cohort study was conducted on 6313 SMI participants with accelerometry data from UK Biobank (mean age 61.05 years) from February 2013 to November 2021 (median 7-year follow-up). Moderate-to-vigorous PA (MVPA) was categorized by meeting the guideline level or not, while total PA and light-intensity PA (LPA) were grouped by tertiles. Incident CVD, all-cause and CVD mortality ascertained by hospital and death registries were main outcomes. Results: PA was inversely associated with the risk for incident CVD (Poverall < 0.05 for total PA and MVPA, Pnonlinearity > 0.05 for all PA), all-cause mortality (Poverall < 0.05 for all PA, Pnonlinearity < 0.05 for total PA and LPA), and CVD mortality (Poverall < 0.001 for total PA and LPA, Pnonlinearity < 0.05 for all PA). Performing guideline-recommended volume of MVPA was associated with a reduced risk of 19% for incident CVD (95% CI, 0.67-0.98), 42% for all-cause mortality (95% CI, 0.43-0.79), and 50% for CVD mortality (95% CI, 0.31-0.82). A combination of recommended MVPA and a moderate volume of LPA was associated with the lowest risk, mitigating 21% risk for incident CVD, 59% for all-cause mortality, and 78% for CVD mortality. Conclusions: Primary engagement of guideline-recommended MVPA, supplemented with moderate amount of LPA, was associated with lower risks for incident CVD, all-cause and CVD mortality among people with SMI. Acknowledgements: This research has been conducted using the UK Biobank Resource under Application Number 58082. Funding Support: This work was supported by the National Natural Science Foundation of China (grant number 32100880), Guangzhou Municipal Key Discipline in Medicine (2021-2023), Guangzhou High-level Clinical Key Specialty, and Guangzhou Research-oriented Hospital. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]