Associations between occupational physical activity and left ventricular structure and function over 25 years in CARDIA

Abstract

Aims Leisure time physical activity (LTPA) confers cardiovascular health benefits, while occupational physical activity (OPA) may have paradoxically negative health associations. This study tested the explanatory hypothesis that unfavourable cardiac remodelling may result from chronic OPA-induced cardiovascular strain. Methods Longitudinal associations of OPA and left ventricular (LV) structure and function were examined in 1462 participants {50.0% and results female, 56.4% White, aged 30.4 ± 3.4 years at baseline [Year 5 exam (1990–91)]} from the Coronary Artery Risk Development in Young Adults study. Left ventricular structure and function were measured as LV mass (LVMi), end-diastolic volume (LVEDVi), end-systolic volume (LVESVi), ejection fraction (LVEF), stroke volume (LVSVi), and e/a-wave ratio (EA ratio) via echocardiography at baseline and 25 years later. Occupational physical activity was reported at seven exams during the study period as months/year with ‘vigorous job activities such as lifting, carrying, or digging’ for ≥5 h/week. The 25-year OPA patterns were categorized into three trajectories: no OPA (n = 770), medium OPA (n = 410), and high OPA (n = 282). Linear regression estimated associations between OPA trajectories and echocardiogram variables at follow-up after adjusting for baseline values, individual demographic/health characteristics, and LTPA. Twenty-five-year OPA exposure was not significantly associated with LVMi, LVEDVi, LVSVi, or EA ratio (P > 0.05). However, higher LVESVi (β = 1.84, P < 0.05) and lower LVEF (β = −1.94, P < 0.05) were observed at follow-up among those in the high- vs. no-OPA trajectories Conclusion The paradoxically adverse association of OPA with cardiovascular health was partially supported by null or adverse associations between high OPA and echocardiogram outcomes. Confirmation is needed using more precise OPA measures.Lay summary This study tested the paradoxical notion that physical activity done for work may not have the same heart health benefits as expected for physical activity done during leisure time. • Those who completed high amounts of physical activity at work had no beneficial changes and, in some cases, adverse changes to the structure and function of their hearts compared with those doing no activity at work during the same period. • The adverse changes associated with physical activity at work were more apparent among men, those with greater than high school education levels, and those with low levels of physical activity outside of work.