Easy Exercise Prevents Mortality in Cardio-Kidney-Metabolic Syndrome

Light-intensity physical activity, even doing common, everyday tasks, may be enough to decrease all-cause death across a range of patients with cardio-kidney-metabolic (CKM) syndrome, according to a new analysis.

Among more than 7,000 adults who had the ability to walk, 3-5 hours of daily light physical activity was linked to as much as a 20% lower relative risk of mortality over 14 years, Joseph Sartini (Johns Hopkins University, Baltimore, MD), and colleagues report online last week in the Journal of the American Heart Association.

“These findings suggest it is important for both clinicians and patients to consider light physical activity interventions when making treatment decisions,” Sartini told TCTMD in an email. “This is particularly crucial for those people who have difficulty engaging in the commonly recommended forms of intense physical activity. For these individuals, light activity may be the only viable way to increase [physical activity].”

While plenty of studies have examined how all levels of physical activity can benefit cardiovascular health, research is limited in patients with CKM syndrome, who often aren’t able to perform higher-intensity activities. Examples of light physical activity include anything from loading the dishwasher to folding laundry.

The new analysis is based on 7,246 adults (mean age 48 years; 52% female) who wore an accelerometry device as part of the National Health and Nutritional Examination Survey (NHANES) between 2003 and 2006.

Patients with CKM stage 0/1 did the most light-intensity physical activity daily (mean 4.8 hours), whereas those with CKM stage 4 did the least (mean 3.5 hours). Light physical activity made up the vast majority of all physical activity across the spectrum of CKM (median ≥ 93.8%) as well as in those with CKM stage 3/4 (median ≥ 98.5%).

Over a median follow-up of 14.4 years, 80 people with CKM stage 0/1 died, as did 583 with stage 2, 565 with stage 3, and 571 with stage 4. After adjustment, greater amounts of light physical activity were associated with lower mortality over time in patients with CKM stages 2-4: each 1-hour increase lowered the relative risk of mortality between 14% and 20%, with the benefit greatest among patients with CKM stage 4.

To TCTMD, senior author Michael Fang, PhD (Johns Hopkins University), said “our findings suggest it is worth considering extending recommendations to include light activity along with the more standard higher intensity activities” for patients with CKM, as well as even those without.

Sartini said he’d like to see additional studies looking at CKM patients that include “measures of physical functioning,” which could help to account for how much CKM is affecting people’s ability to engage in light activities. Doing so would enable clinicians to better tap into the “overlooked tool” of light physical activity for the “90% of the population” that’s affected by CKM, he said.