Association between physical activity level and cardiovascular disease: An empirical analysis based on CHARLS data in 2018

Objective: Cardiovascular disease (CVD) was a global public health challenge. This study aimed to investigate the association between physical activity level (PAL) and CVD among middle-aged and older adults in China, to provide evidence to inform strategies for CVD prevention and management. Methods: The diagnosis of CVD was based on self-reported physician-diagnosed heart disease or stroke, while PAL were classified using calculations derived from a structured questionnaire. Both datasets were obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS) survey. A multivariate logistic regression model was used for the primary correlation analysis. Additionally, restricted cubic spline (RCS) regression was employed to examine the potential nonlinear association between PAL and CVD. Results: The final analysis included 9,015 participants, 1,069 of whom were diagnosed with CVD, yielding a prevalence of 11.86%. After adjusting for all covariates, the multivariate-adjusted odds ratios (ORs) for the moderate PAL group (600−3000 MET-minutes/week) and the high PAL group (>3000 MET-minutes/week) were 0.79 (95% CI: 0.64–0.97) and 0.72 (95% CI: 0.60–0.87), respectively, compared to the low PAL group ( 0.05), indicating that the OR for CVD decreased with higher levels of PAL. Conclusions: This study revealed a negative correlation between PAL and the prevalence of CVD. Furthermore, our findings suggested that middle-aged and older adults should maintain moderate to high levels of physical activity, as this was associated with a lower risk of CVD.