SaO008PHYSICAL ACTIVITY REDUCES 10-YEAR CARDIOVASCULAR DISEASE RISK THROUGH IMPROVEMENT IN BLOOD PRESSURE REGULATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Abstract

INTRODUCTION: Cardiovascular disease (CVD) remains a leading cause of death for patients with chronic kidney disease (CKD) and for renal transplant recipients (RTRs). Risk factors include smoking, obesity, hypertension, and hypercholesterolaemia. Increased physical activity reduces CVD mortality risk in general populations, with guidelines recommending adults engage ≥150 minutes of weekly physical activity. Nonetheless, evidence between physical activity and CVD risk in renal populations is lacking. We aimed to explore the relationship between physical activity, CVD risk factors, and 10-year CVD risk in CKD and RTRs groups. METHODS: Physical activity was assessed in 63 non-dialysis dependentCKDpatients and 33 RTRs using the 'General practice physical activity questionnaire' (GPPAQ). Patients were defined as eithermeeting current physical activity recommendations ('Active') or not ('Inactive'). Classic CVDrisk factors (smoking history, diabetes, systolic (SBP) and diastolic blood pressure, BMI, cholesterol (total,HDL, LDL)weremeasured. TheQRISK3 algorithm was used to predict 10-year CVD risk (i.e. risk of developing a heart attack or stroke over the next 10 years).Datawere analysed using univariate linearmodelling. RESULTS: CKD: 51/63 (81%) of patients were classified as 'Inactive'. 'Inactive' patients were older (P 130 mmHg (P=.039). No differences were seen in lipid profiles (cholesterol, HDL, and LDL) (P=.106 to .836) or BMI (P=.338). 'Active' RTRs had a lower prevalence of hypertension (P=.025) and were less likely to be a past/current smoker (P=.046). Being 'Active' was associated with a significant 9% [95CI:0 to 19] reduction in 10-year CVD risk compared 'Inactive' patients; a relative reduction of 53% (P=.048). The largest predictors of 10-year CVDrisk were age, sex, incidence of diabetes, and elevated SBP. Pertinently, higher physical activity was significantly associated with a lower SBP of∼7 to 16mmHg and a 39% reduction in hypertension prevalence (in RTRs). CONCLUSIONS: Physically 'active' patients had a 9 to 12% reduction in 10-year CVD risk. This reduced risk was possibly mediated by the favorable and clinically meaningful effects (∼7 to 16 mmHg) of physical activity on lowering SBP and reducing the occurrence of hypertension. A worryingly large number of non-dialysis CKD patients (81%) and RTRs (92%) do not meet the recommended amount of physical activity. Further evidence is needed that modifying physical activity can reduce clinical outcomes in these populations.