{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:15Z","timestamp":1785218415087,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sleep duration and physical activity are intertwined determinants of cardiovascular health, yet their joint impact remains unclear. This study evaluated their independent, joint, and interactive associations with cardiovascular disease using a rigorous confounding adjustment framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed pooled data from 1,577,591 US adults in the Behavioral Risk Factor Surveillance System (2014\u20132022). Inverse probability of treatment weighting and doubly robust logistic regression were used. Additive interaction was assessed via RERI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both short sleep (odds ratio, 1.26; 95% confidence interval, 1.22\u20131.30) and long sleep (odds ratio, 1.17; 95% confidence interval, 1.13\u20131.21) were independently associated with prevalent cardiovascular disease, as was physical inactivity (odds ratio, 1.11; 95% confidence interval, 1.09\u20131.14). The joint effect of short sleep and inactivity conferred the highest risk (odds ratio, 1.38; 95% confidence interval, 1.31\u20131.44). The relative excess risk due to interaction was \u22120.03 (95% confidence interval, \u22120.11 to 0.06), indicating additive, independent risks without synergy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>By applying a rigorous adjustment framework, this study provides actionable, population-level evidence that moves beyond simple risk factor identification. Public health strategies should integrate sleep hygiene and physical activity into holistic \u201c24-h movement\u201d prescriptions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1886068","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:37:09Z","timestamp":1785217029000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Independent and joint associations of sleep duration and physical activity with cardiovascular disease: a cross-sectional study of 1.6 million US adults"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuqin","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Radiology, Shandong First Medical University Affiliated Tumor Hospital","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Ming","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Abdominal Medical Imaging","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e41","DOI":"10.1161\/CIR.0000000000001303","article-title":"2025 heart disease and stroke statistics: a report of US and global data from the American Heart Association","volume":"151","author":"Martin","year":"2025","journal-title":"Circulation"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1016\/S0140-6736(25)01637-X","article-title":"Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990-2023: a systematic analysis for the global burden of disease study 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