AB1320-HPR THE ASSOCIATION BETWEEN PHYSICAL ACTIVITY AND CARDIORESPIRATORY FITNESS IN PATIENTS WITH RHEUMATOID ARTHRITIS AND HIGH CARDIOVASCULAR RISK
Authors: J. Van den Hoek, M. Van der Leeden, G. Metsios, G. Kitas, H. Jorstad, W. Lems, M. Nurmohamed, M. Van der Esch
Journal: Annals of the Rheumatic Diseases (2020)

Background: Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular disease (CVD) disease and CV mortality 1 . High values of cardiorespiratory fitness (CRF) are protective against CVD and CV mortality 2 . Physical activity levels in patients with RA are low. Knowledge on whether physical activity is associated with CRF in patients with RA and high CV risk is scarce. This knowledge is important because improving the level of physical activity could improve CRF and lower CV risk in this group of patients with RA and high CV risk. However, it is unclear whether physical activity is associated with CRF in this group of patients. This study presents the preliminary results at baseline of the association of physical activity with CRF from an ongoing pilot study aimed at improving CRF through exercise therapy in patients with RA and high CV risk. Objectives: To determine (i) the level of physical activity in patients with RA and high CV risk and (ii) whether physical activity is associated with CRF in patients with RA and high CV risk. Methods: Patients with RA and high CV risk participated in this pilot study. Increased 10-year risk of CV mortality was determined by using the Dutch SCORE-table. Anthropometrics and disease characteristics were collected. Physical activity was assessed with an Actigraph accelerometer to determine the number of steps and intensity of physical activity expressed in terms of sedentary, light, and moderate-to-vigorous time per day. Participants wore the accelerometer for seven days. A minimum of four measurement days with a wear time of at least 10 hours was required. The VO 2 max measured with a graded maximal exercise test was used to determine the CRF. Pearson correlation coefficients were calculated for the associations between the different measures of physical activity and VO 2 max. For the variables that were associated, linear regression analysis was carried out, with pain and disease activity as possible confounders. Results: Thirteen females and five males were included in the study. The mean age was 66.5 (± 15.0) years. Only 22% of the patients met public health physical activity guidelines for the minimal amount of 150 minutes a week. The mean step count was 6237 (± 2297) steps per day and mean moderate-to-vigorous physical activity time was 16.50 (± 23.56) minutes per day. The median VO 2 max was 16.23 [4.63] ml·kg -1 ·min -1 , which is under the standard. Pearson correlations showed a significant positive association for step count with VO 2 max. No associations were found for sedentary, light, and moderate-to-vigorous physical activity with VO 2 max. The significant association between step count and VO 2 max(p = 0.01) was not confounded by disease severity and pain. Discussion: Since better CRF protects against CVD, increasing daily step count may be a simple way to reduce the risk of CVD in patients with RA and high CV risk. However, these results need to be confirmed in a larger study group. Future research should investigate if improving daily step count will lead to better CRF levels and ultimately will lead to a reduction in CV risk in patients with RA and high CV risk. Conclusion: Physical activity levels of patients with RA and high CV risk do not meet public health requirements for physical activity criteria and the VO 2 max was under the standard. Step count is positively associated with CRF. References: [1]Agca et al. Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders. Heart. 2016;102(10):790-795. [2]Lemes et al. Cardiorespiratory fitness and risk of all-cause, cardiovascular disease, and cancer mortality in men with musculoskeletal conditions. J Phys Act Health. 2019;16;134-140. Disclosure of Interests: Joëlle van den Hoek: None declared, Marike van der Leeden: None declared, George Metsios: None declared, Georeg Kitas: None declared, Harald Jorstad: None declared, WIllem Lems Grant/research support from: Pfizer, Consultant of: Lilly, Pfizer, Michael Nurmohamed Grant/research support from: Not related to this research, Consultant of: Not related to this research, Speakers bureau: Not related to this research, Martin van der Esch: None declared