Background/Purpose: Patients with Rheumatoid arthritis (RA) tend to perform less physical activity compared to the recommended guidelines. The long-term effects of physical activity on mortality and cardiorenal events are not well understood. 

The aim of this study was to assess the relationship between physical activity and the risk of mortality in individuals with RA, along with exploring the dose-response relationship of physical activity on mortality.

Methods: The research evaluated self-reported physical activity data from 520 participants, obtained through the Physical Activity Questionnaire (PAQ) as part of the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. Patients were categorized into highly active ( >25 MET-h/week), low-active (0.1 to ≤ 25 MET-h/week), or inactive (0 MET-h/week) groups. Cox regression and restricted cubic spline (RCS) models were utilized to investigate the association between physical activity and the risks of all-cause and cardiovascular mortality.

Results: During a median follow-up of 11.1 years, 146 all-cause deaths and 44 cardiovascular deaths occurred. The hazard ratio (HR) for all-cause mortality was 0.46 [95% confidence interval (CI): 0.28, 0.75] for the highly active group compared to the inactive group, and the HR for cardiovascular mortality was 0.43 (95% CI: 0.13, 1.40). RCS model showed a non-linear dose-response relationship between physical activity and all-cause mortality, with the most active participants experiencing the largest reduction in mortality risk. 

Conclusion: Physical activity of >25 MET-h/week is associated with lower risks of all-cause mortality and should be integrated into RA management strategies to reduce mortality risk.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/effect-of-physical-activity-on-mortality-in-rheumatoid-arthritis-a-dose-response-analysis/