Physical activity, sedentary behavior and risk of coronary artery disease, myocardial infarction and ischemic stroke: a two-sample Mendelian randomization study

Clin Res Cardiol. 2021 Oct;110(10):1564-1573. doi: 10.1007/s00392-021-01846-7. Epub 2021 Mar 27.

Abstract

Aims: Observational evidence suggests that physical activity (PA) is inversely and sedentarism positively related with cardiovascular disease risk. We performed a two-sample Mendelian randomization (MR) analysis to examine whether genetically predicted PA and sedentary behavior are related to coronary artery disease, myocardial infarction, and ischemic stroke.

Methods and results: We used single nucleotide polymorphisms (SNPs) associated with self-reported moderate to vigorous PA (n = 17), accelerometer based PA (n = 7) and accelerometer fraction of accelerations > 425 milli-gravities (n = 7) as well as sedentary behavior (n = 6) in the UK Biobank as instrumental variables in a two sample MR approach to assess whether these exposures are related to coronary artery disease and myocardial infarction in the CARDIoGRAMplusC4D genome-wide association study (GWAS) or ischemic stroke in the MEGASTROKE GWAS. The study population included 42,096 cases of coronary artery disease (99,121 controls), 27,509 cases of myocardial infarction (99,121 controls), and 34,217 cases of ischemic stroke (404,630 controls). We found no associations between genetically predicted self-reported moderate to vigorous PA, accelerometer-based PA or accelerometer fraction of accelerations > 425 milli-gravities as well as sedentary behavior with coronary artery disease, myocardial infarction, and ischemic stroke.

Conclusions: These results do not support a causal relationship between PA and sedentary behavior with risk of coronary artery disease, myocardial infarction, and ischemic stroke. Hence, previous observational studies may have been biased.

Keywords: 2 sample MR; Coronary Artery Disease; Myocardial infarction; Physical activity.

MeSH terms

  • Accelerometry
  • Adult
  • Aged
  • Brain Ischemia / epidemiology
  • Brain Ischemia / etiology
  • Brain Ischemia / genetics
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / genetics
  • Exercise / genetics
  • Exercise / statistics & numerical data*
  • Female
  • Genome-Wide Association Study
  • Humans
  • Ischemic Stroke / epidemiology*
  • Ischemic Stroke / etiology
  • Ischemic Stroke / genetics
  • Male
  • Mendelian Randomization Analysis
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / genetics
  • Polymorphism, Single Nucleotide
  • Risk Factors
  • Sedentary Behavior