Associations of Accelerometer-Derived "Weekend Warrior" Physical Activity Pattern With Incident First Cardiometabolic Disease and Cardiometabolic Multimorbidity in Individuals With Hypertension.

BACKGROUND: To examine associations between accelerometer-derived "weekend warrior" (WW) physical activity pattern (most moderate-to-vigorous-intensity physical activity in 1-2 days) versus moderate-to-vigorous-intensity physical activity spread more evenly with risks of incident first cardiometabolic disease (FCMD) and cardiometabolic multimorbidity (CMM) among hypertension participants. METHODS: UK Biobank participants with hypertension (n=26891) provided a full-week of accelerometer-derived physical activity data between 2013 and 2015, processed using GGIR and a machine-learning classifier. CMM was defined as the occurrence of at least 2 of type 2 diabetes, ischemic heart disease, and stroke. Three activity patterns (WW, regular, and inactive) were compared across multiple thresholds and definitions of active WW, with significance corrected for multiple comparisons at a false discovery rate of 0.05. RESULTS: Over 7.5 years median follow-up, 2718 individuals developed FCMD and 219 developed CMM. Using the definition of WW as guideline-based and ≥50% of total moderate-to-vigorous-intensity physical activity over 1 to 2 days via GGIR, we observed similarly lower risks of incident FCMD (WW versus inactive: hazard ratio [HR], 0.75 [95% CI, 0.69-0.82], P=1.4 × 10-3; regular versus inactive: HR, 0.85 [95% CI, 0.74-0.96], P=2.6 × 10-2) and CMM (WW versus inactive: HR, 0.59 [95% CI, 0.41-0.83], P=4.0 × 10-3). Both active WW and regular physical activity patterns were associated with lower risk of FCMD compared with inactivity, with no statistically significant differences between the 2 active patterns. However, the result of WW versus inactive for CMM showed no statistical significance. CONCLUSIONS: Increased activity, even when concentrated within 1 to 2 days/week may reduce cardiometabolic disease risk in individuals with hypertension.