The impact of accelerometer wear location on the relationship between step counts and arterial stiffness in adults treated for hypertension and diabetes

Abstract

ObjectivesAccelerometer placement at the wrist is convenient and increasingly adopted despite less accurate physical activity (PA) measurement than with waist placement. Capitalizing on a study that started with wrist placement and shifted to waist placement, we compared associations between PA measures derived from different accelerometer locations with a responsive arterial health indicator, carotid-femoral pulse wave velocity (cfPWV). DesignCross-sectional study. MethodsWe previously demonstrated an inverse association between waist-worn pedometer-assessed step counts (Yamax SW-200, 7 days) and cfPWV (−0.20m/s, 95% CI −0.28, −0.12 per 1000 step/day increment) in 366 adults. Participants concurrently wore accelerometers (ActiGraph GT3X+), most at the waist but the first 46 at the wrist. We matched this subgroup with participants from the ‘waist accelerometer’ group (sex, age, and pedometer-assessed steps/day) and assessed associations with cfPWV (applanation tonometry, Sphygmocor) separately in each subgroup through linear regression models. ResultsCompared to the waist group, wrist group participants had higher step counts (mean difference 3980 steps/day; 95% CI 2517, 5443), energy expenditure (967kcal/day, 95% CI 755, 1179), and moderate-to-vigorous-PA (138min; 95% CI 114, 162). Accelerometer-assessed step counts (waist) suggested an association with cfPWV (−0.28m/s, 95% CI −0.58, 0.01); but no relationship was apparent with wrist-assessed steps (0.02m/s, 95% CI −0.24, 0.27). ConclusionsWaist but not wrist ActiGraph PA measures signal associations between PA and cfPWV. We urge researchers to consider the importance of wear location choice on relationships with health indicators.