Accelerometer-derived weekend warrior physical activity pattern and all-cause and cause-specific mortality in patients with cardiovascular disease

AIMS: Although weekend warrior physical activity is linked to lower mortality in the general population, whether it confers similar benefits among individuals with cardiovascular disease (CVD) remains unknown. This study aimed to investigate the association between a weekend warrior activity pattern and mortality in patients with CVD. METHODS AND RESULTS: We performed a sub-cohort analysis of 8,128 UK Biobank participants with CVD. Physical activity patterns were defined by weekly moderate-to-vigorous physical activity (MVPA) volume and distribution: weekend warrior (≥150 min/week MVPA, with ≥50% accumulated on 1-2 days), regularly active (≥150 min/week MVPA spread over >2 days), and inactive (<150 min/week MVPA). Outcomes were all-cause, CVD-specific, and cancer-specific mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) for mortality across activity patterns. Of the participants, 3,004 (44.09%) were weekend warriors, 1,540 (18.95%) were regularly active, and 3,584 (36.96%) were inactive. Over a median follow-up of 7.85 years, 881 deaths occurred. Compared with the inactive pattern, both weekend warrior (HR, 0.61; 95% CI: 0.52-0.71) and regularly active (HR, 0.68; 95% CI: 0.56-0.82) patterns were associated with lower risks of all-cause mortality among participants with CVD. Similar associations were observed for CVD- and cancer-specific mortality. CONCLUSIONS: Among individuals with CVD, the weekend warrior pattern was associated with a lower risk of mortality, with survival benefits comparable to those observed for the regularly active pattern. This pattern may serve as a practical alternative for patients who have difficulty maintaining regular activity across the week.