Morning Physical Activity Is Associated With the Lowest Risk of Heart Disease and Stroke

Summary: Those who exercised early in the morning or later in the day had a lower risk of coronary artery disease by 11 percent and 16 percent, respectively. Those who exercised later in the morning were 17 percent less likely to have a stroke than the control group.
resource: european society of cardiology
Morning physical activity is linked to the lowest risk of heart disease and stroke, according to a study of more than 85,000 people published today European Journal of Preventive Cardiology.
The findings were consistent regardless of the total amount of daily activity.
“Exercise is known to be beneficial for heart health, and our study now shows that morning activity appears to be most beneficial,” said study author Ms Gali Albalak from the Leiden University Medical Center in the Netherlands. “This finding was especially pronounced in women, and applies to both early birds and night owls.”
The study used data from the UK Biobank. It included 86,657 adults aged 42 to 78 who were free of cardiovascular disease at baseline. The mean age was 62 years, and 58% were women. Participants wore an activity tracker on their wrist for 7 consecutive days. Participants were followed for a cardiovascular disease event, defined as a first hospitalization or death related to coronary artery disease or stroke.
During six to eight years of follow-up, 2,911 participants developed coronary artery disease and 796 had strokes. Comparing peak activity times over a 24-hour period, being most active between 8am and 11am was associated with the lowest risk of heart disease and stroke.
In a second analysis, the researchers divided participants into four groups based on peak times of physical activity: 1) midday; 2) early morning (~8 am); 3) late morning (~10 am); and 4 ) at night (~7pm).
These categories were chosen based on the time of peak activity of the study population, rather than being predetermined before the study began. The association between time of peak activity and cardiovascular disease events was analyzed using noon as a reference group.
After adjusting for age and sex, participants who were most active in the early morning or early evening had an 11 percent and 16 percent lower risk of coronary artery disease, respectively, compared with the reference group. In addition, those who were most active in the late morning had a 17 percent lower risk of stroke compared with the reference group.

The findings were consistent regardless of total daily activity and whether participants described themselves as morning or late risers. When the results were analyzed separately by sex, the researchers found that the results were particularly pronounced in women but no longer significant in men.
Women who were most active in the morning or evening had a 22 percent and 24 percent lower risk of coronary artery disease, respectively, compared with the reference group. In addition, women who were most active in the late morning had a 35 percent lower risk of stroke compared with the reference group.
“This was an observational study, so we could not explain why the association was stronger in women,” Ms. Albalak said. Our findings suggest that morning activity, especially early morning activity, may be most beneficial, increasing Evidence for the health benefits of physical activity.
“It's too early to formally recommend prioritizing morning exercise, as this is a whole new field of research. But we hope that one day we can improve on the current advice by simply adding a line: ‘When exercise, it's advised to do so in the morning.'”
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resource: european society of cardiology
touch: Press Office – European Society of Cardiology
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Original research: open access.
Gali Albalak et al. “Set your clock: the association between objective physical activity time and cardiovascular disease risk in the general population”. European Journal of Preventive Cardiology
Abstract
Set your clock: the association between objective physical activity time and cardiovascular disease risk in the general population
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purpose
Little is known about the impact of daily physical activity time (referred to here as ‘time activity') on cardiovascular disease (CVD) risk. Our aim was to examine the association between temporal activity and multiple CVD outcomes in the UK Biobank.
Methods and Results
During a 7-day measurement period, UK Biobank collected physical activity data via triaxial accelerometers. We used K-means clustering to create clusters of participants with similar temporal activity, regardless of average daily intensity of physical activity.
Multivariable adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) comparing different clusters adjusted for age and sex (model 1) and baseline cardiovascular risk factors (model 2). Additional stratified analyzes were performed by sex, mean activity level, and type of self-reported sleep duration. We included 86 657 people (58% female, mean age: 61.6 [SD: 7.8] years, average BMI: 26.6 [4.5] kg/square meter2). During the 6-year follow-up period, 3707 CVD events were reported.
Overall, they had less coronary artery disease (HR: 0.84, 95% CI: 0.77, 0.92) and stroke (HR: 0.83, 95% CI: 0.70, 0.98) risk was lower among participants with midday physical activity patterns. These effects were more pronounced in women (P– Interaction value = 0.001). We found no evidence to support an effect of modification by total activity level and sleep chronotype.
in conclusion
Regardless of total physical activity, morning physical activity was associated with lower cardiovascular disease risk, highlighting the potential importance of temporal activity in CVD prevention.