Abstract P126: Physical Activity, Family History of Premature Coronary Heart Disease, and Incident Atherosclerotic Cardiovascular Disease in the Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Background: Family history (FHx) of coronary heart disease (CHD) is a well-established risk factor for incident atherosclerotic cardiovascular disease (ASCVD). Certain interventions (e.g. smoking cessation) may be more effective in those with a FH of CHD. Physical activity (PA) is associated with reduced risk of ASCVD. Whether this association varies by FHx of premature CHD is not well established. Methods: We evaluated 9,996 ARIC participants free of ASCVD, and with data on FHx of CHD or PA at Visit 1 (1987-1989). FHx of premature CHD was defined as CHD occurring in a father before the age 55 or in a mother before age 60, as reported by each participant. PA was assessed using a modified Baecke questionnaire, subsequently converted into min/wk of moderate or vigorous exercise. PA was categorized as per AHA guidelines as recommended, intermediate, or poor (see footnote to Table ). Incident ASCVD was defined as incident myocardial infarction, fatal CHD, or stroke. Multivariable adjusted Cox proportional hazard models were used. Results: The mean age was 54±6 years, 56% were women and 21% of black race. Participants with FHx of premature CHD had more adverse lipid profiles but otherwise similar ASCVD risk factors. Participants with and without a FHx of premature CHD reported similar levels of PA at baseline (409 vs 423 MET/min/week, respectively, p=0.85), and approximately 40% of both groups met AHA recommended PA levels. Over a mean follow-up of 20.9 years, there were 1,723 incident ASCVD events. Compared with poor, recommended levels of PA were associated with a significantly lower risk of incident ASCVD ( Table ) without a significant interaction by FHx status (p-interaction=0.68). Conclusion: Despite their FHx and their more adverse lipid profiles, individuals with a FHx of premature CHD had similar PA patterns as compared to those without a FHx, with less than half meeting AHA recommended levels. PA was similarly beneficial against incident ASCVD for both groups. Promotion of PA should be encouraged for all regardless of FHx status.