Prevention & lipidsCohort study
Combined variations in sleep, physical activity, and nutrition and the risk of major adverse cardiovascular events
- Prospective cohort study
Authors' conclusion
Modest differences in combined SPAN behaviour levels were associated with meaningful reductions in MACE risk.
Study context
- Population
- UK Biobank participants with wearable-measured sleep and moderate to vigorous physical activity (MVPA) and diet quality score (median age 63.0 years; 56.8% male)2,034 major adverse cardiovascular events (MACE) events
- Participants
- 53,242 participants
- Exposure
- Combined SPAN behaviour levels
- Outcome
- MACE and its subtypes (myocardial infarction (MI), heart failure (HF), stroke)
- Follow-up
- 8.0-year follow-up
Main finding
As reported in the abstract
MACE
Each group vs lowest tertile for all SPAN behavioursHR
Optimal SPAN combination57% lower risk
0.43(95% CI 0.30–0.62)
Median SPAN score (52.8)41% lower risk
0.59(95% CI 0.49–0.70)
Additional 11 min/day sleep, 4.5 min/day MVPA and 3 DQS points10% lower MACE risk
0.90(CI 0.88–0.94)
Observational data: associations, not effects.
Further findings
| Outcome | HR | |
|---|---|---|
| MACE subtypes, median SPAN score — Median SPAN score vs Lowest tertile for all SPAN behaviours · HF | 0.53 (CI 0.38–0.75) | |
| MACE subtypes, median SPAN score — Median SPAN score vs Lowest tertile for all SPAN behaviours · MI | 0.65 (95% CI 0.50–0.84) | |
| MACE subtypes, median SPAN score — Median SPAN score vs Lowest tertile for all SPAN behaviours · stroke | 0.52 (95% CI 0.38–0.71) | |
| 0.20.5125Hazard ratio (log scale) |
Synergistic interaction between SPAN behaviours for MACE
- No synergistic interaction observed; RERI
- 0.003 (95% CI: −0.03, 0.04)
- Attributable proportion (AP)
- 0.4% (95% CI: −6 to 7%)
- S
- 1.03 (95% CI: −3.32, 5.29)
Original publication
Combined variations in sleep, physical activity, and nutrition and the risk of major adverse cardiovascular events. Eur J Prev Cardiol. Published 23 March 2026. doi:10.1093/eurjpc/zwag141
Summarised from the published abstract; every number is checked against it