Preventing Chronic Disease | Associations Between Physical Activity and Cardiometabolic Risk Factors Assessed in a Southern California Health Care System, 2010–2012 - CDC
Associations Between Physical Activity and Cardiometabolic Risk Factors Assessed in a Southern California Health Care System, 2010–2012
Deborah Rohm Young, PhD; Karen J. Coleman, PhD; Eunis Ngor, MS; Kristi Reynolds, PhD; Margo Sidell, PhD; Robert E. Sallis, MD
Suggested citation for this article: Young DR, Coleman KJ, Ngor E, Reynolds K, Sidell M, Sallis RE. Associations Between Physical Activity and Cardiometabolic Risk Factors Assessed in a Southern California Health Care System, 2010–2012. Prev Chronic Dis 2014;11:140196. DOI: http://dx.doi.org/10.5888/pcd11.140196
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Abstract
Introduction
Risk factors associated with many chronic diseases can be improved through regular physical activity. This study investigated whether cross-sectional associations between physical activity, assessed by the Exercise Vital Sign (EVS), and cardiometabolic risk factors can be detected in clinical settings.
Risk factors associated with many chronic diseases can be improved through regular physical activity. This study investigated whether cross-sectional associations between physical activity, assessed by the Exercise Vital Sign (EVS), and cardiometabolic risk factors can be detected in clinical settings.
Methods
We used electronic records from Kaiser Permanente Southern California members (N = 622,897) to examine the association of EVS category with blood pressure, fasting glucose, random glucose, and glycosylated hemoglobin. Adults aged 18 years or older with at least 3 EVS measures between April 2010 and December 2012, without comorbid conditions, and not taking antihypertension or glucose-lowering medications were included. We compared consistently inactive (EVS = 0 min/wk for every measure) with consistently active (EVS ≥150 min/wk) and irregularly active (EVS 1–149 min/wk or not meeting the consistently active or inactive criteria) patients. Separate linear regression analyses were conducted controlling for age, sex, race/ethnicity, body mass index, and smoking status.
We used electronic records from Kaiser Permanente Southern California members (N = 622,897) to examine the association of EVS category with blood pressure, fasting glucose, random glucose, and glycosylated hemoglobin. Adults aged 18 years or older with at least 3 EVS measures between April 2010 and December 2012, without comorbid conditions, and not taking antihypertension or glucose-lowering medications were included. We compared consistently inactive (EVS = 0 min/wk for every measure) with consistently active (EVS ≥150 min/wk) and irregularly active (EVS 1–149 min/wk or not meeting the consistently active or inactive criteria) patients. Separate linear regression analyses were conducted controlling for age, sex, race/ethnicity, body mass index, and smoking status.
Results
Consistently active women had lower systolic (−4.60 mm Hg; 95% confidence interval [CI], −4.70 to −4.44) and diastolic (−3.28 mm Hg; 95% CI, −3.40 to −3.17) blood pressure than inactive women. Active men had lower diastolic blood pressure than inactive men. Consistently active patients (women, −5.27 mg/dL [95% CI, −5.56 to −4.97]; men, −1.45 mg/dL [95% CI, −1.75 to −1.16] and irregularly active patients (women, −4.57 mg/dL [95% CI, −4.80 to −4.34]; men, −0.42 mg/dL [95% CI, −0.66 to −0.19]) had lower fasting glucose than consistently inactive patients. Consistently active and irregularly active men and women also had favorable random glucose and HbA1c compared with consistently inactive patients.
Consistently active women had lower systolic (−4.60 mm Hg; 95% confidence interval [CI], −4.70 to −4.44) and diastolic (−3.28 mm Hg; 95% CI, −3.40 to −3.17) blood pressure than inactive women. Active men had lower diastolic blood pressure than inactive men. Consistently active patients (women, −5.27 mg/dL [95% CI, −5.56 to −4.97]; men, −1.45 mg/dL [95% CI, −1.75 to −1.16] and irregularly active patients (women, −4.57 mg/dL [95% CI, −4.80 to −4.34]; men, −0.42 mg/dL [95% CI, −0.66 to −0.19]) had lower fasting glucose than consistently inactive patients. Consistently active and irregularly active men and women also had favorable random glucose and HbA1c compared with consistently inactive patients.
Conclusion
Routine clinical physical activity assessment may give health care providers additional information about their patients’ cardiometabolic risk factors.
Routine clinical physical activity assessment may give health care providers additional information about their patients’ cardiometabolic risk factors.
Introduction
During the past 60 years, many studies have demonstrated that regular physical activity reduces illness and death from numerous diseases, including coronary heart disease (1,2), hypertension (3,4), diabetes (5,6), and stroke (7). Exercise training studies and more generalizable population-based physical activity interventions show that risk factors associated with these chronic diseases, including blood pressure (8,9), blood glucose (10,11), and glycemic control (10,12), can be improved.
Most of the relevant literature includes adults who have been recruited into some type of study on the basis of strict selection criteria, limiting the generalizability of results to those responding to recruitment efforts (13). Few studies have examined associations between physical activity and cardiometabolic risk factors in community settings, such as health care organizations, findings of which may provide greater generalizability than those from the existing literature. The generalizability of health care settings will only increase as the Affordable Care Act is implemented and all Americans are required by law to obtain health care coverage. By studying health care settings, we have the unique opportunity to provide real-world guidance to health care providers and their patients about how health behaviors, such as physical activity, can provide direct benefits to patients.
In 2009, Kaiser Permanente Southern California (KPSC) created and implemented an Exercise Vital Sign (EVS) to be assessed, along with height, weight, and blood pressure, at every adult outpatient visit (14). This study used the EVS to determine whether associations between moderate to vigorous physical activity (MVPA) and blood pressure, blood glucose, and glycosylated hemoglobin (HbA1c) measures could be detected in clinical settings.
Acknowledgments
This work was supported by the Southern California Permanente Medical Group. The authors have no conflicts of interest to declare.
Author Information
Corresponding Author: Deborah Rohm Young, PhD, Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena CA 91101. Telephone: 626-564-3887. E-mail: Deborah.r.young@kp.org.
Author Affiliations: Karen J. Coleman, Eunis Ngor, Kristi Reynolds, Margo Sidell, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California; Robert E. Sallis, Department of Family Medicine, Fontana Medical Center, Kaiser Permanente Southern California, Fontana, California.
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