Physical inactivity, overweight and cardiovascular risk: COVID-Inconfidentes Study

Background Cardiovascular diseases (CVD) currently occupy first place in terms of global morbidity and mortality, and physical activity (PA) is an important modifiable strategy that acts directly on CVD and indirectly on weight loss and maintenance. Objective To investigate the association between physical inactivity and cardiovascular risk (CVR) mediated by excess weight in adults. Methods This is a population-based epidemiological household survey carried out in two Brazilian municipalities. Face-to-face interviews were conducted using a structured questionnaire in electronic format. Participants were classified as physically active or inactive according to World Health Organization (WHO) guidelines. The mediating variable was the presence of overweight based on reported weight and height. CVR was estimated using the Framingham Risk Score (FRS), categorized as low risk (< 5%) or intermediate to high risk (≥ 5%). Data analysis consisted of descriptive analysis and univariate and multivariate logistic regression to examine the association between physical inactivity (FI) and CVR. Mediation analysis was performed using the Karlson-Holm-Breen method to verify the influence of overweight on the association. Results A total of 1,690 individuals were interviewed, 46.3% aged between 35 and 59 and 50.7% female. In the multivariate analysis (OR: 1.89; 95%CI; 1.10–3.24) FI was associated with intermediate to high cardiovascular risk, and 17.18% of this effect was mediated by overweight (OR:1.11; 95%CI; 1.02–1.25). Conclusions These findings suggest that FI increases the chances of cardiovascular risk, and part of this association can be explained by being overweight.