Association between physical activity domains and cardiovascular diseases among US adults: evidence from NHANES 2007–2020

This study examined the associations between different domains of physical activity, leisure-time (LTPA), occupational (OPA), and transportation-related (TPA), and cardiovascular disease (CVD) risk among U.S. adults. Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2008 through March 2020 were used. Physical activity was self-reported using the Global Physical Activity Questionnaire. Weekly minutes of LTPA, OPA, and TPA were calculated and categorized as: <150, 150-299, and ≥ 300 min. CVD was defined as self- or proxy-reported heart failure, coronary heart disease, angina, heart attack, or stroke. Weighted multivariable logistic regression was used to assess associations. Six sensitivity analyses were conducted. Meeting the physical activity guidelines (≥ 150 min/week) through LTPA or TPA was associated with significantly lower odds of CVD, 22% [OR: 0.78, 95% CI: 0.70-0.88] and 40% [OR: 0.60, 95% CI: 0.50-0.72], respectively. This was supported by sensitivity analyses. In a separate dose-response analysis, individuals engaging in twice the recommended minimum (≥ 300 min/week) experienced even greater reductions in CVD risk, with 30% lower odds for LTPA [OR: 0.70, 95% CI: 0.60-0.80] and 41% lower odds for TPA [OR: 0.59, 95% CI: 0.47-0.74]. In contrast, OPA was not significantly associated with CVD risk at any activity level. Among U.S. adults, higher LTPA and TPA are associated with lower CVD risk, particularly at higher levels of activity. In contrast, OPA does not show the same protective effect. The associations between physical activity and CVD risk vary by context.