Associations of temporal patterns of objectively measured moderate-to-vigorous physical activity with mortality in the general population and people with abnormal glucose metabolism or hypertension

To investigate the association between temporal patterns of objectively measured moderate-to-vigorous physical activity (MVPA) and all-cause and cause-specific mortality in the general population and people with abnormal glucose metabolism (AGM) or hypertension. This prospective cohort study collected accelerometer data from the National Health and Nutrition Examination Survey from 2003 to 2006 with linkage to the National Death Index records through 31 December 2019 in the United States. Baseline 7-day accelerometry data were analysed and participants were categorized into 5 groups: morning/midday (05:00-13:59), afternoon (14:00-16:59), evening (17:00-19:59), night (20:00-00:59), and mixed MVPA timing groups. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) between temporal patterns and mortality. A total of 5976 adults (mean [SE] age, 46.4 [0.5] years; 52.1% women) were included and 1371 participants died during a median follow-up of 14.6 years. Compared with the mixed group, the night group had 22% to 77% higher risks of all-cause and cardiovascular mortality in the overall sample and AGM and hypertension subsamples. In people with hypertension, the morning/midday group showed a 31% higher risk of cardiovascular mortality. For those with AGM, the evening group had 90% to 185% higher risks of all-cause and cardiovascular mortality.