Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk

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dc.contributor.authorBöhm, Michael
dc.contributor.authorSchumacher, Helmut
dc.contributor.authorWerner, Christian
dc.contributor.authorTeo, Koon K
dc.contributor.authorLonn, Eva M
dc.contributor.authorMahfoud, Felix
dc.contributor.authorSpeer, Thimoteus
dc.contributor.authorMancia, Giuseppe
dc.contributor.authorRedon, Josep
dc.contributor.authorSchmieder, Roland E
dc.contributor.authorSliwa, Karen
dc.contributor.authorMarx, Nikolaus
dc.contributor.authorWeber, Michael A
dc.contributor.authorLaufs, Ulrich
dc.contributor.authorWilliams, Bryan
dc.contributor.authorYusuf, Salim
dc.contributor.authorMann, Johannes F E
dc.date.accessioned2022-04-07T11:04:35Z
dc.date.available2022-04-07T11:04:35Z
dc.date.issued2022-01-20
dc.date.updated2022-01-23T05:33:04Z
dc.description.abstractBackground: Guidelines recommend physical activity to reduce cardiovascular (CV) events. The association between physical activity and progression of chronic kidney disease (CKD) with and without diabetes is unknown. We assessed the association of self-reported physical activity with renal and CV outcomes in high-risk patients aged ≥ 55 years over a median follow-up of 56 months in post-hoc analysis of a previously randomized trial program. Methods Analyses were done with Cox regression analysis, mixed models for repeated measures, ANOVA and χ2-test. 31,312 patients, among them 19,664 with and 11,648 without diabetes were analyzed. Results Physical activity was inversely associated with renal outcomes (doubling of creatinine, end-stage kidney disease (ESRD)) and CV outcomes (CV death, myocardial infarction, stroke, heart failure hospitalization). Moderate activity (at least 2 times/week to every day) was associated with lower risk of renal outcomes and lower incidence of new albuminuria (p < 0.0001 for both) compared to lower exercise levels. Similar results were observed for those with and without diabetes without interaction for renal outcomes (p = 0.097–0.27). Physical activity was associated with reduced eGFR decline with a moderate association between activity and diabetes status (p = 0.05). Conclusions Moderate physical activity was associated with improved kidney outcomes with a threshold at two sessions per week. The association of physical activity with renal outcomes did not meaningfully differ with or without diabetes but absolute benefit of activity was even greater in people with diabetes. Thus, risks were similar between those with diabetes undertaking high physical activity and those without diabetes but low physical activity. Clinical trial registration: http://clinicaltrials.gov.uniqueidentifier :NCT00153101.
dc.identifier.apacitationBöhm, M., Schumacher, H., Werner, C., Teo, K. K., Lonn, E. M., Mahfoud, F., ... Mann, J. F. E. (2022). Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk. <i>Cardiovascular Diabetology</i>, 21(1), 12. http://hdl.handle.net/11427/36289en_ZA
dc.identifier.chicagocitationBöhm, Michael, Helmut Schumacher, Christian Werner, Koon K Teo, Eva M Lonn, Felix Mahfoud, Thimoteus Speer, et al "Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk." <i>Cardiovascular Diabetology</i> 21, 1. (2022): 12. http://hdl.handle.net/11427/36289en_ZA
dc.identifier.citationBöhm, M., Schumacher, H., Werner, C., Teo, K.K., Lonn, E.M., Mahfoud, F., Speer, T. & Mancia, G. et al. 2022. Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk. <i>Cardiovascular Diabetology.</i> 21(1):12. http://hdl.handle.net/11427/36289en_ZA
dc.identifier.ris TY - Journal Article AU - Böhm, Michael AU - Schumacher, Helmut AU - Werner, Christian AU - Teo, Koon K AU - Lonn, Eva M AU - Mahfoud, Felix AU - Speer, Thimoteus AU - Mancia, Giuseppe AU - Redon, Josep AU - Schmieder, Roland E AU - Sliwa, Karen AU - Marx, Nikolaus AU - Weber, Michael A AU - Laufs, Ulrich AU - Williams, Bryan AU - Yusuf, Salim AU - Mann, Johannes F E AB - Background: Guidelines recommend physical activity to reduce cardiovascular (CV) events. The association between physical activity and progression of chronic kidney disease (CKD) with and without diabetes is unknown. We assessed the association of self-reported physical activity with renal and CV outcomes in high-risk patients aged ≥ 55 years over a median follow-up of 56 months in post-hoc analysis of a previously randomized trial program. Methods Analyses were done with Cox regression analysis, mixed models for repeated measures, ANOVA and χ2-test. 31,312 patients, among them 19,664 with and 11,648 without diabetes were analyzed. Results Physical activity was inversely associated with renal outcomes (doubling of creatinine, end-stage kidney disease (ESRD)) and CV outcomes (CV death, myocardial infarction, stroke, heart failure hospitalization). Moderate activity (at least 2 times/week to every day) was associated with lower risk of renal outcomes and lower incidence of new albuminuria (p < 0.0001 for both) compared to lower exercise levels. Similar results were observed for those with and without diabetes without interaction for renal outcomes (p = 0.097–0.27). Physical activity was associated with reduced eGFR decline with a moderate association between activity and diabetes status (p = 0.05). Conclusions Moderate physical activity was associated with improved kidney outcomes with a threshold at two sessions per week. The association of physical activity with renal outcomes did not meaningfully differ with or without diabetes but absolute benefit of activity was even greater in people with diabetes. Thus, risks were similar between those with diabetes undertaking high physical activity and those without diabetes but low physical activity. Clinical trial registration: http://clinicaltrials.gov.uniqueidentifier :NCT00153101. DA - 2022-01-20 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Cardiovascular Diabetology KW - Physical activity KW - Cardiovascular outcomes KW - Renal outcomes KW - Secondary prevention LK - https://open.uct.ac.za PY - 2022 T1 - Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk TI - Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk UR - http://hdl.handle.net/11427/36289 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12933-021-01429-w
dc.identifier.urihttp://hdl.handle.net/11427/36289
dc.identifier.vancouvercitationBöhm M, Schumacher H, Werner C, Teo KK, Lonn EM, Mahfoud F, et al. Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk. Cardiovascular Diabetology. 2022;21(1):12. http://hdl.handle.net/11427/36289.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central
dc.publisher.departmentHatter Institute for Cardiovascular Research in Africa & IIDMM
dc.publisher.facultyFaculty of Health Sciences
dc.rights.holderThe Author(s)
dc.sourceCardiovascular Diabetology
dc.source.journalissue1
dc.source.journalvolume21
dc.source.pagination12
dc.source.urihttps://cardiab.biomedcentral.com/
dc.subjectPhysical activity
dc.subjectCardiovascular outcomes
dc.subjectRenal outcomes
dc.subjectSecondary prevention
dc.titleAssociation between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk
dc.typeJournal Article
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