Abstract Body: Background and Aims: The benefits of physical activity against atherosclerotic cardiovascular disease are well established, but their role in reducing the risk of aortic aneurysm (AA) remains uncertain. This study aimed to investigate the association between moderate-to-vigorous physical activity (MVPA) and the incidence of AA in mid-aged and older adults.
Methods: Utilizing data from the UK Biobank, the primary analysis examined accelerometer-derived MVPA data from 88,005 participants (median age: 62.9 years; female: 56.4%), while the secondary analysis was based on questionnaire-reported MVPA data from 382,268 participants (median age: 57.0 years; female: 52.4%). The primary outcome was the diagnosis of AA incidents, with secondary outcomes included those of abdominal AA (AAA), and thoracic AA and dissection (TAAD). We also examined the joint effects and interactions between MVPA and genetic predisposition on the risks of AAA and TAAD.
Results: In the accelerometer-derived cohort, we identified 426 incident AA events, comprising 249 AAA and 167 TAAD cases, over a median follow-up of 6.56 years. The adjusted hazard ratios (HRs) for AA across MVPA quartiles Q2–Q4 versus Q1 were 0.73 (95% CI: 0.57-0.92), 0.58 (95% CI: 0.44-0.76), and 0.51 (95% CI: 0.37-0.70); for AAA, the corresponding HRs were 0.64 (95% CI: 0.47-0.87), 0.54 (95% CI: 0.38-0.77), and 0.37 (95% CI: 0.24-0.59); and for TAAD, the HRs were 0.98 (95% CI: 0.67-1.42), 0.69 (95% CI: 0.45-1.07), and 0.60 (95% CI: 0.37-0.98). For the joint associations, the lowest risks of AAA and TAAD were observed among participants with the highest MVPA quartile and low genetic risk (AAA: HR, 0.25; 95% CI, 0.14-0.44; TAAD: HR, 0.38; 95% CI, 0.21-0.69), compared with those with the lowest MVPA volume and high genetic risk. Similar but less apparent associations were observed in the questionnaire-based cohort.
Conclusions: Higher levels of MVPA are associated with a reduced risk of AA, especially AAA. These results highlight that physical activity may serve as a modifiable risk factor in the primary prevention of AA. Further studies with prolonged follow-up or diverse populations are needed to validate and expand on these results.