Mediterranean diet and other lifestyle factors in relation to 20-year all-cause mortality: a cohort study in an Italian population

The aim of the present analysis was to evaluate the association of the Mediterranean diet (MeDi), smoking habits and physical activity with all-cause mortality in an Italian population during a 20-year follow-up study. A total of 1693 subjects aged 40–74 who enrolled in the study in 1991–5 were asked about dietary and other lifestyle information at baseline. Adherence to the MeDi was evaluated by the Mediterranean dietary score (MedDietScore). A healthy lifestyle score was computed by assigning 1 point each for a medium or high adherence to the MedDietScore, non-smoking and physical activity. Cox models were used to assess the associations between lifestyle factors and healthy lifestyle scores and all-cause mortality, adjusting for potential confounders. The final sample included 974 subjects with complete data and without chronic disease at baseline. During a median of 17·4 years of follow-up, 193 people died. Subjects with high adherence to the MedDietScore (hazard ratio (HR) 0·62, 95 % CI 0·43, 0·89)), non-smokers (HR 0·71, 95 % CI 0·51, 0·98) and physically active subjects (HR 0·55, 95 % CI 0·36, 0·82) were at low risk of death. Each point increase in the MedDietScore was associated with a significant 5 % reduction of death risk. Subjects with 1, 2 or 3 healthy lifestyle behaviours had a significantly 39, 56, and 73 % reduced risk of death, respectively. A high adherence to MeDi, non-smoking and physical activity were strongly associated with a reduced risk of all-cause mortality in healthy subjects after long-term follow-up. This reduction was even stronger when the healthy lifestyle behaviours were combined.

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Can a simple measure of vigorous physical activity predict future mortality? Results from the OXCHECK study

Public Health Nutrition ◽

10.1079/phn2003548 ◽

2004 ◽

Vol 7 (4) ◽

pp. 557-562 ◽

Cited By ~ 14

Author(s):

Melvyn Hillsdon ◽

Margaret Thorogood ◽

Mike Murphy ◽

Lesley Jones

Keyword(s):

Physical Activity ◽

Cox Regression ◽

Vigorous Physical Activity ◽

Previous History ◽

Self Report ◽

Moderate Intensity ◽

Risk Of Death ◽

All Cause Mortality ◽

Intensity Physical Activity

AbstractBackground:As epidemiological studies have become more complex, demands for short, easily administered measures of risk factors have increased. This study investigates whether such a measure of physical activity is associated with the risk of death from all causes and death from specific causes.Methods:A prospective follow-up study of 11 090 men and women, aged 35–64 years, recruited from five UK general practices who responded to a postal questionnaire in 1989. Self-reported frequency of vigorous-intensity physical activity and data on confounding factors were collected at baseline survey. Death notifications up to 31 December 2001 were provided by the Office for National Statistics. The relative risk (and 95% confidence interval) of dying associated with each level of exposure to physical activity was estimated by the hazard ratio in a series of Cox regression models.Results:After > 10 years' follow-up there were 825 deaths among the 10 522 subjects with no previous history of angina or myocardial infarction. Participation in vigorous exercise was associated with a significantly lower risk of all-cause mortality. Similar associations were found for ischaemic heart disease and cancer mortality, although the relationships were not significant at the 5% level.Conclusions:Simple measures of self-reported vigorous physical activity are associated with the risk of future mortality, at least all-cause mortality in a somewhat selected group. Interpretation of the finding should be treated with caution due to the reliance on self-report and the possibility that residual confounding may underlie the associations. Because moderate-intensity physical activity is also beneficial to health, short physical activity questionnaires should include measures of such physical activity in the future.

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Abstract 11597: Voluntary and Occupational Physical Activity Have Different Effects on Mortality

Circulation ◽

10.1161/circ.132.suppl_3.11597 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Martin Bahls ◽

Sebastian Baumeister ◽

Henry Völzke ◽

Sven Gläser ◽

Michael Leitzmann ◽

...

Keyword(s):

Physical Activity ◽

Oxygen Consumption ◽

Cancer Mortality ◽

Leisure Time ◽

Large Population ◽

Cardiopulmonary Exercise Testing ◽

All Cause Mortality ◽

Reduced Risk ◽

Cvd Mortality

Introduction: Animal studies suggest oppositional effects for voluntary and involuntary physical activity (PA). To assess this in humans, we used distinct domains of PA (sports, leisure time, work) as well as physical fitness and associated these variables with all-cause, cardiovascular (CVD) and cancer mortality in a large population-based cohort. Methods: Data of 2,925 participants from the Study of Health in Pomerania (SHIP-1) were used [median age: 48 (interquartile range (IQR): 35, 62) years (y), 52% [[female symbol]]]. All-cause and cause-specific mortality was determined after a median follow-up of 7.0 y (IQR: 5.6 - 6.2). A Sports index (SI), Leisure Time index (LTI) and Work index (WI) were assessed using a modified Baecke questionnaire. Maximal oxygen consumption (VO2peak), oxygen consumption at the anaerobic threshold (VO2@AT), and maximal work load (Wmax) were measured on a bicycle ergometer during symptom-limited cardiopulmonary exercise testing (CPET). Cox models were adjusted for sex, age, smoking, alcohol consumption, years of schooling, income, and body mass index. Results: A total of 156 subjects died due to all-cause, 53 due to CVD and 50 due to cancer after follow-up. After adjustment, SI [hazard ratio (HR) per SD: 0.27; 95%-confidence interval (CI): 0.13; 0.55] and LTI (HR per SD: 0.34; 95%-CI: 0.15; 0.77) were associated with a reduced risk of all-cause mortality. WI was not associated with all-cause mortality. SI was associated with reduced risk of CVD mortality (HR: 0.26; 95%-CI: 0.07; 0.96). All CPET measures were significantly related to reduced risk of all-cause and cancer mortality (VO2peak - all-cause HR per SD: 0.007; 95%-CI: 0.001; 0.057 and cancer HR per SD: 0.011; 95%-CI: 0.005; 0.210; VO2@AT - all-cause HR per SD: 0.047; 95%-CI: 0.001; 0.028 and cancer HR per SD: 0.052; 95%-CI: 0.004; 0.073; Wmax - all-cause HR per SD: 0.012; 95%-CI: 0.002; 0.074 and cancer HR per SD: 0.01; 95%-CI: 0.0007; 0.166). Conclusion: Voluntary PA was associated with a reduced risk for all-cause and CVD mortality, while occupational PA was not. Exercise capacity was inversely related to all-cause and cancer mortality. Our results indicate that the benefits of PA may be limited to voluntary PA. Thus, questionnaires need to differentiate between voluntary and occupational PA.

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Low serum klotho associated with all-cause mortality among a nationally representative sample of American adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glab308 ◽

2021 ◽

Author(s):

Jacob K Kresovich ◽

Catherine M Bulka

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Representative Sample ◽

Cox Regression ◽

The United States ◽

Risk Of Death ◽

All Cause Mortality ◽

Nationally Representative ◽

Low Serum

Abstract α-Klotho (klotho) is a protein involved in suppressing oxidative stress and inflammation. In animal models, it is reported to underlie numerous aging phenotypes and longevity. Among a nationally representative sample of adults aged 40 to 79 in the United States, we investigated whether circulating concentrations of klotho is a marker of mortality risk. Serum klotho was measured by ELISA on 10,069 individuals enrolled in the National Health and Nutrition Examination Survey between 2007-2014. Mortality follow-up data based on the National Death Index were available through December 31, 2015. After a mean follow-up of 58 months (range: 1-108), 616 incident deaths occurred. Using survey-weighted Cox regression models adjusted for age, sex and survey cycle, low serum klotho concentration (< 666 pg/mL) was associated with a 31% higher risk of death (compared to klotho concentration > 985 pg/mL, HR: 1.31, 95% CI: 1.00, 1.71, P= 0.05). Associations were consistent for mortality caused by heart disease or cancer. Associations of klotho with all-cause mortality did not appear to differ by most participant characteristics. However, we observed effect modification by physical activity, such that low levels of serum klotho were more strongly associated with mortality among individuals who did not meet recommendation-based physical activity guidelines. Our findings suggest that, among the general population of American adults, circulating levels of klotho may serve as a marker of mortality risk.

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Cognitive Impairment and Physical Activity in Old Age: The Impact on All-Cause Mortality in a 15-Year Follow-Up of the Bambuí Cohort Study of Aging

SSRN Electronic Journal ◽

10.2139/ssrn.3557992 ◽

2020 ◽

Author(s):

Erico Castro-Costa ◽

Jerson Laks ◽

Cecilia Godoi Campos ◽

Josélia OA Firmo ◽

Maria Fernanda Lima-Costa ◽

...

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Cognitive Impairment ◽

Old Age ◽

All Cause Mortality ◽

The Impact

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Benefits of tafamidis in patients with advanced transthyretin amyloid cardiomyopathy

European Heart Journal ◽

10.1093/ehjci/ehaa946.2115 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Rapezzi ◽

A.V Kristen ◽

B Gundapaneni ◽

M.B Sultan ◽

M Hanna

Keyword(s):

Disease Severity ◽

Nyha Class ◽

Funding Source ◽

Class Iii ◽

Private Company ◽

Risk Of Death ◽

6Mwt Distance ◽

All Cause Mortality ◽

Amyloid Cardiomyopathy

Abstract Background In the Tafamidis in Transthyretin Cardiomyopathy Clinical Trial (ATTR-ACT), tafamidis was shown to be an effective treatment for patients with transthyretin amyloid cardiomyopathy (ATTR-CM). Further assessment of the efficacy of tafamidis in patients with more advanced ATTR-CM would aid treatment decisions. Purpose To characterize the benefits of tafamidis in patients with advanced ATTR-CM. Methods In ATTR-ACT, ATTR-CM patients were randomized to tafamidis (n=264) or placebo (n=177) for 30 months. Efficacy outcomes included all-cause mortality and frequency of cardiovascular (CV)-related hospitalisations. Key secondary endpoints were change from baseline to Month 30 in 6MWT distance and KCCQ-OS score. Efficacy assessments in NYHA Class III patients at baseline (n=141) were a pre-specified analysis. In a post-hoc analysis, mortality and CV-related hospitalizations were assessed in all patients grouped into quartiles of increasing disease severity based on 6MWT distance at baseline. Longer-term all-cause mortality (as of 1 Aug 2019) was assessed in NYHA Class III patients utilizing data from ATTR-ACT patients who enrolled in a long-term, extension study (LTE) and continued treatment with higher dose tafamidis (n=55; median treatment duration 51.6 months); or, if previously treated with placebo, started tafamidis treatment (placebo/tafamidis; n=63 [50.1 months]). Results In advanced ATTR-CM patients (NYHA Class III), tafamidis reduced the risk of death (HR [95% CI] 0.837, [0.541, 1.295], P=0.4253), and the decline in 6MWT distance (LS mean [SE], 31.6 (22.1) m; P=0.1526) and KCCQ-OS score (LS mean [SE], 13.1 (5.0); P=0.0090), vs placebo. Paradoxically, there was a higher frequency of CV-related hospitalizations with tafamidis (RR [95% CI] vs placebo, 1.411 [1.048, 1.900]). In all patients by 6MWT quartile, CV-related hospitalizations/year with tafamidis and placebo increased with disease severity, with the exception that placebo-treated patients in the highest severity quartile had fewer CV-related hospitalisations (0.73) than those in the third quartile (0.92). Mortality with tafamidis and placebo increased, and was greater with placebo, in every quartile (Figure). Survival (NYHA Class III patients in ATTR-ACT and LTE) was improved with high dose tafamidis with longer term follow-up (HR vs placebo/tafamidis [95% CI], 0.6569 [0.4175, 1.0336]; P=0.0692). Conclusions These analyses, including longer-term follow-up, demonstrate that patients with advanced ATTR-CM benefit from tafamidis. The decrease in CV-related hospitalisations in more severe patients treated with placebo suggests that the comparatively greater hospitalisation frequency in NYHA Class III patients treated with tafamidis is a consequence of their lower mortality rate. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): This study was sponsored by Pfizer

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Intervention for unruptured high-grade intracranial dural arteriovenous fistulas: a multicenter study

Journal of Neurosurgery ◽

10.3171/2021.1.jns202799 ◽

2021 ◽

pp. 1-9

Author(s):

Ching-Jen Chen ◽

Thomas J. Buell ◽

Dale Ding ◽

Ridhima Guniganti ◽

Akash P. Kansagra ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Intervention Group ◽

Group Versus ◽

Symptomatic Improvement ◽

High Grade ◽

Type Ii ◽

Risk Of Death ◽

All Cause Mortality

OBJECTIVE The risk-to-benefit profile of treating an unruptured high-grade dural arteriovenous fistula (dAVF) is not clearly defined. The aim of this multicenter retrospective cohort study was to compare the outcomes of different interventions with observation for unruptured high-grade dAVFs. METHODS The authors retrospectively reviewed dAVF patients from 12 institutions participating in the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR). Patients with unruptured high-grade (Borden type II or III) dAVFs were included and categorized into four groups (observation, embolization, surgery, and stereotactic radiosurgery [SRS]) based on the initial management. The primary outcome was defined as the modified Rankin Scale (mRS) score at final follow-up. Secondary outcomes were good outcome (mRS scores 0–2) at final follow-up, symptomatic improvement, all-cause mortality, and dAVF obliteration. The outcomes of each intervention group were compared against those of the observation group as a reference, with adjustment for differences in baseline characteristics. RESULTS The study included 415 dAVF patients, accounting for 29, 324, 43, and 19 in the observation, embolization, surgery, and SRS groups, respectively. The mean radiological and clinical follow-up durations were 21 and 25 months, respectively. Functional outcomes were similar for embolization, surgery, and SRS compared with observation. With observation as a reference, obliteration rates were higher after embolization (adjusted OR [aOR] 7.147, p = 0.010) and surgery (aOR 33.803, p < 0.001) and all-cause mortality was lower after embolization (imputed, aOR 0.171, p = 0.040). Hemorrhage rates per 1000 patient-years were 101 for observation versus 9, 22, and 0 for embolization (p = 0.022), surgery (p = 0.245), and SRS (p = 0.077), respectively. Nonhemorrhagic neurological deficit rates were similar between each intervention group versus observation. CONCLUSIONS Embolization and surgery for unruptured high-grade dAVFs afforded a greater likelihood of obliteration than did observation. Embolization also reduced the risk of death and dAVF-associated hemorrhage compared with conservative management over a modest follow-up period. These findings support embolization as the first-line treatment of choice for appropriately selected unruptured Borden type II and III dAVFs.

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Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098733 ◽

2018 ◽

Vol 53 (16) ◽

pp. 1013-1020 ◽

Cited By ~ 67

Author(s):

Barbara J Jefferis ◽

Tessa J Parsons ◽

Claudio Sartini ◽

Sarah Ash ◽

Lucy T Lennon ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behaviour ◽

Vigorous Physical Activity ◽

Older Men ◽

Population Based ◽

Physical Activity Guidelines ◽

All Cause Mortality ◽

Sedentary Breaks ◽

Objectively Measured

ObjectivesTo understand how device-measured sedentary behaviour and physical activity are related to all-cause mortality in older men, an age group with high levels of inactivity and sedentary behaviour.MethodsProspective population-based cohort study of men recruited from 24 UK General Practices in 1978–1980. In 2010–2012, 3137 surviving men were invited to a follow-up, 1655 (aged 71–92 years) agreed. Nurses measured height and weight, men completed health and demographic questionnaires and wore an ActiGraph GT3x accelerometer. All-cause mortality was collected through National Health Service central registers up to 1 June 2016.ResultsAfter median 5.0 years’ follow-up, 194 deaths occurred in 1181 men without pre-existing cardiovascular disease. For each additional 30 min in sedentary behaviour, or light physical activity (LIPA), or 10 min in moderate to vigorous physical activity (MVPA), HRs for mortality were 1.17 (95% CI 1.10 to 1.25), 0.83 (95% CI 0.77 to 0.90) and 0.90 (95% CI 0.84 to 0.96), respectively. Adjustments for confounders did not meaningfully change estimates. Only LIPA remained significant on mutual adjustment for all intensities. The HR for accumulating 150 min MVPA/week in sporadic minutes (achieved by 66% of men) was 0.59 (95% CI 0.43 to 0.81) and 0.58 (95% CI 0.33 to 1.00) for accumulating 150 min MVPA/week in bouts lasting ≥10 min (achieved by 16% of men). Sedentary breaks were not associated with mortality.ConclusionsIn older men, all activities (of light intensity upwards) were beneficial and accumulation of activity in bouts ≥10 min did not appear important beyond total volume of activity. Findings can inform physical activity guidelines for older adults.

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Abstract 5008: Lifestyle Practices in Adults 65 Years and Older and 7-Year Follow-up Mortality: The Chicago Heart Association Detection Project in Industry Study (CHA)

Circulation ◽

10.1161/circ.118.suppl_18.s_1129-d ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Thanh Huyen T Vu ◽

Daniel B Garside ◽

Martha L Daviglus

Keyword(s):

Healthy Lifestyle ◽

Heavy Drinking ◽

Heart Association ◽

Older Age ◽

Unhealthy Lifestyle ◽

Industry Study ◽

Hazard Ratios ◽

Lifestyle Practices ◽

All Cause Mortality

Background and Objective : Prospective data on combined effects of lifestyle practices (smoking, heavy drinking, and physical inactivity) in older age on mortality are limited. We examine the combined impact of lifestyle behaviors in adults 65 years and older on CVD, non-CVD, cancer, and all-cause mortality after 7 years of follow-up. Methods : In 1996, a health survey was mailed to all surviving participants, ages 65–102, from the Chicago Heart Association Detection Project in Industry Study. The response rate was 60% and the sample included 4,200 male and 3,288 female respondents. Unhealthy lifestyle (un-HL) practices were classified into three groups as having two or more , one , or none of the following three un-HL factors (current smoking or stopped smoking only within the past 10 years; heavy drinking ->15 g/day for women or >30 g/day for men; and infrequent exercise). Vital status was ascertained through 2003 via the National Death Index. Results : With adjustment for age, race, education, marital status, living arrangement, and BMI, the hazards of CVD, non-CVD, cancer, and all-cause mortality were highest among men and women who had two or more un-HL factors and lowest among those who had healthy lifestyle. For example, in men, compared to those with none un-HL factors, the hazard ratios (95%CIs) of all-cause death for those with two or more and one un-HL factors were 2.10 (1.73–2.46) and 1.56 (1.36–1.77), respectively. Associations were attenuated somewhat but remained strongly significant with further adjustment for comorbidities (see table ). Conclusion : Having no unhealthy lifestyle factors in older age is associated with a lower risk for CVD, non-CVD, cancer, and all-cause death. These results should encourage healthy lifestyle practices in elderly people to decrease mortality and promote longevity. Adjusted* Hazard Ratios (95% CIs) for CVD, Non-CVD, Cancer, and All-Cause Death by Number of Unhealthy Lifestyle Factors in 1996 and Gender

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COVID-19 and hematologic diseases: Risk factors and long-term follow-up of CHRONOS19 Registry.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18715 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18715-e18715

Author(s):

Kristina Zakurdaeva ◽

Olga A. Gavrilina ◽

Anastasia N. Vasileva ◽

Sergei Dubov ◽

Vitaly S. Dubov ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Disease Progression ◽

Primary Endpoint ◽

Acute Leukemias ◽

Risk Of Death ◽

All Cause Mortality ◽

Long Term Follow Up

e18715 Background: Pts with hem diseases are at high risk of COVID-19 severe course and mortality. Emerging data on risk factors and outcomes in this patient population is of great value for developing strategies of medical care. Methods: CHRONOS19 is an ongoing nationwide observational cohort study of adult (≥18 y) pts with hem disease (both malignant and non-malignant) and lab-confirmed or suspected (clinical symptoms and/or CT) COVID-19. Primary objective was to evaluate treatment outcomes. Primary endpoint was 30-day all-cause mortality. Long-term follow-up was performed at 90 and 180 days. Data from 14 centers was collected on a web platform and managed in a deidentified manner. Results: As of data cutoff on January 27, 2021, 575 pts were included in the registry, 486 of them eligible for primary endpoint assessment, n(%): M/F 243(50%)/243(50%), median age 56 [18-90], malignant disease in 452(93%) pts, induction phase/R/R/remission 160(33%)/120(25%)/206(42%). MTA in 93(19%) pts, 158(33%) were transfusion dependent, comorbidities in 278(57%) pts. Complications in 335(69%) pts: pneumonia (67%), CRS (8%), ARDS (7%), sepsis (6%). One-third of pts had severe COVID-19, 25% were admitted to ICU, 20% required mechanical ventilation. All-cause mortality at 30 days – 17%; 80% due to COVID-19 complications. At 90 days, there were 14 new deaths: 6 (43%) due to hem disease progression. Risk factors significantly associated with OS are listed in Tab 1. In multivariate analysis – ICU+mechanical ventilation, HR, 53.3 (29.1-97.8). Acute leukemias were associated with higher risk of death, HR, 2.40 (1.28-4.51), less aggressive diseases (CML, CLL, MM, non-malignant) – with lower risk of death, HR, 0.54 (0.37-0.80). No association between time of COVID-19 diagnosis (Apr-Aug vs. Sep-Jan) and risk of death. COVID-19 affected treatment of hem disease in 65% of pts, 58% experienced treatment delay for a median of 4[1-10] weeks. Relapse rate on Day 30 and 90 – 4%, disease progression on Day 90 detected in 13(7%) pts; 180-day data was not mature at the time of analysis. Several cases of COVID-19 re-infection were described. Conclusions: Thirty-day all-cause mortality in pts with hem disease was higher than in general population with COVID-19. Longer-term follow-up (180 days) for hem disease outcomes and OS will be presented. [Table: see text]

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Abstract P281: All-cause and Cardiovascular Mortality in Men With High Levels of Physical Activity and Coronary Artery Calcification

Circulation ◽

10.1161/circ.137.suppl_1.p281 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Laura F Defina ◽

Nina B Radford ◽

David Leonard ◽

Stephen W Farrell ◽

Andjelka Pavlovic ◽

...

Keyword(s):

Physical Activity ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Proportional Hazards ◽

Subclinical Atherosclerosis ◽

Activity Level ◽

Mortality Hazard ◽

Hazard Ratios ◽

All Cause Mortality

Introduction: Recent studies have suggested that extreme levels of physical activity (endurance athletes) are associated with subclinical atherosclerosis as well as increased mortality. The safety of continuing high levels of physical activity is uncertain once coronary artery calcification (CAC) is discovered. Hypothesis: We hypothesized that men performing &ge3000 MET·minutes/week of physical activity would have greater all-cause and cardiovascular (CV) mortality compared to those with &lt1500 or 1500-&lt3000 MET·minutes/week of physical activity and that mortality risk would be greater in those with CAC&ge100 compared to &lt100 Agatston units. Methods: The cohort studied included 16,109 men without prevalent CV disease who reported physical activity levels and underwent EBT or MDCT scan. Physical activity was categorized into &ge3000 (n=1,266), 1500-3000 (n=3,027), and &lt1500 (n=11,816) MET·minutes/week. CAC scanning included EBT scans (1997-2007) or MDCT scans (2007-2013), and CAC score was categorized into &ge100 (n=3,547) and &lt100 (n=12,562) Agatston units. We fit separate proportional hazards regression models to follow-up times for all-cause and CV mortality. The models included all combinations of CAC and physical activity categories and were adjusted for baseline age, smoking, BMI, cholesterol, HDLc, and systolic blood pressure. Results: The average age of participants at baseline was 51.3±8.3 years. Men with the highest activity level had a lower BMI and higher HDLc. After an average follow-up of 8.9 years, there were 329 all-cause and 60 CV deaths, including 174 all-cause and 38 CV deaths in those with CAC&ge100. The sample had 80% power to detect all-cause mortality hazard ratios &ge 1.9 and 1.8 for physical activity &ge3000 versus &lt1500 in those with CAC&lt100 and &ge100, respectively. The corresponding minimum detectable CV mortality hazard ratios were 3.5 and 2.8. Comparing physical activity &ge3000 to &lt1500 in those with CAC&ge100, the hazard ratios (95% CI) were 0.9 (0.5, 1.5) for all-cause mortality and 0.9 (0.3, 3.1) for CV mortality. Hazard ratios were similar when comparing physical activity &ge3000 to 1500-&lt3000 in those with CAC &ge100. Finally, when comparing physical activity categories, there was no evidence that hazard ratios varied by CAC category, p&gt0.7. Conclusions: This sample offers no evidence that levels of activity &ge3000 MET·minutes/week are associated with increased all-cause or CV mortality compared to those with &lt1500 or 1500- &lt3000 MET·minutes/week, regardless of CAC level.

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