Wearable device-measured physical activity and incident cardiovascular disease in cancer survivors

Objective To explore the association of wearable device-measured moderate-to-vigorous intensity physical activity (MVPA) with cardiovascular disease (CVD) risk in long-term cancer survivors. Methods This retrospective analysis involved a prospective cohort of 6109 cancer survivors without CVD from the UK Biobank accelerometry subsample. The MVPA volume is categorised into four groups based on guideline recommendations (0–75 min/week, 75–150 min/week, 150–300 min/week, ≥300 min/week). Cox proportional hazard models are used to investigate the association of MVPA with incident CVD. Results Over a median follow-up of 7.88 years, there were 539 incident CVD events (361 incident coronary artery disease (CAD) events, 155 incident heart failure (HF) events, and 109 incident stroke events). Adjusted CVD incidence rates (95% CIs) across MVPA groups (0–75 min/week, 75–150 min/week, 150–300 min/week, ≥300 min/week) were 15.30 (12.90, 18.10), 13.50 (11.00, 16.40), 12.00 (10.20, 14.10) and 9.86 (8.35, 11.60) per 1000 person-years, respectively. Adjusted HRs (95% CI) for CVD, CAD, HF and stroke in the highest MVPA group (≥300 min/week) compared with those in the lowest MVPA group (0–75 min/week) were 0.63 (0.49, 0.80), 0.68 (0.51, 0.91), 0.66 (0.42,1.06) and 0.72 (0.42, 1.23), respectively. For obesity-related cancers, the beneficial effect on CVD was observed when exceeding 300 MVPA min/week (HR 0.54 (0.37–0.81)) compared with the lowest MVPA group. Conclusions Findings from the UK Biobank study suggest that longer MVPA durations are associated with reduced CVD risk in cancer survivors, underscoring the potential for physical activity to serve as a key component in cardio-oncology care.