Background/Purpose: Patients with SLE are at increased risk for atherosclerotic cardiovascular disease (ASCVD). As sedentary behavior and lack of physical activity (PA) have been identified as ASCVD risk factors in the general population, we investigated the relationship between habitual PA levels and estimated 10-year ASCVD risk among patients with SLE. We also evaluated the association between habitual PA levels and individual ASCVD risk factors in SLE.

Methods: For this cross-sectional study, patients were recruited from an SLE clinic at a single academic medical center. All participants met the ACR classification criteria for SLE. Patients were excluded if they had a prior history of ASCVD. Habitual PA was measured using triaxial accelerometers worn during waking hours for seven consecutive days. Minutes per day of total sedentary time, prolonged sedentary bouts (≥30 uninterrupted sedentary minutes), light activity, and moderate-vigorous physical activity (MVPA) were recorded. Cardiovascular risk factors included body mass index, blood pressure, fasting glucose and lipid profile. Ten-year ASCVD risk was calculated using the 2013 American College of Cardiology (ACC) / American Heart Association (AHA) risk assessment tool. Associations between time spent in each PA category and calculated 10-year ASCVD risk were assessed using multivariable linear regression models. The relationships between PA at each intensity level and individual cardiovascular risk markers were also evaluated using multivariable linear regression, adjusting for age and gender.

Results: There were 100 SLE patients (mean ± SD age 52.4 ± 14.4 years, 92% female). Participants spent a total of 10.0 hours/day being sedentary, 2.2 hours/day engaged in light activity, and 29.8 minutes/day engaged in MVPA. Median (IQR) time spent in prolonged sedentary bouts was 35.4 (36.8) minutes/day, with 21% of participants spending > 1 hour/day in prolonged sedentary behavior. Only 11% of participants met the Canadian Physical Activity Guidelines for MVPA (≥ 150 minutes/week in 10 minute bouts). Regression models demonstrated that time spent in MVPA was inversely associated with calculated 10-year ASCVD risk (R² Δ = 0.10; p=0.001). Time spent in prolonged sedentary bouts was positively associated with 10-year risk of ASCVD (R² Δ = 0.06; p=0.016), independent of time spent in MVPA (R² Δ = 0.03; p=0.049). MVPA performance was also inversely associated with both systolic (R² Δ = 0.07; p=0.005) and diastolic blood pressure (R² Δ = 0.07; p=0.007), after adjusting for age, gender, and antihypertensive use. Neither total sedentary time nor time spent in light activity were significantly associated with 10-year ASCVD risk, nor were they associated with any of the individual cardiovascular risk markers we evaluated.

Conclusion: Among patients with SLE, those at higher risk for ASCVD perform less MVPA. Prolonged sedentary behavior is associated with ASCVD risk in SLE, independent of MVPA performance. Our findings highlight the need for effective PA interventions to increase habitual MVPA levels and reduce prolonged sedentary time in this high-risk population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/habitual-physical-activity-sedentary-behavior-and-cardiovascular-disease-risk-burden-in-systemic-lupus-erythematosus-sle/