Cardiovascular disease (CVD) is a major global health burden, particularly among overweight and obese individuals. We aimed to investigate associations between different physical activity patterns (concentrated activity vs. regularly active) and incident CVD, and to compare their effects in this specific population.

Data were from the UK Biobank, with 49,368 overweight and obese individuals (63.50 ± 7.73 years; 51.4% women) included in this study from 2006–2010. Participants were categorized into three physical activity patterns: inactive (< 150 min/week of moderate-to-vigorous physical activity (MVPA)), regularly active (≥ 150 min/week of MVPA, with ≥ 50% of activity distributed over > 2 days/week), and concentrated activity (≥ 150 min/week of MVPA, with ≥ 50% concentrated on 1–2 days/week).

In fully adjusted models, both the concentrated activity and regularly active patterns had a similar magnitude of CVD risk reduction compared with inactive individuals, overall CVD (concentrated activity: HR [95% CI]: 0.79 [0.74–0.85]; regularly active: 0.76 [0.70–0.83]), myocardial infarction (concentrated activity: 0.77 [0.67–0.88]; regularly active: 0.64 [0.53–0.76]), atrial fibrillation (concentrated activity: 0.81 [0.73–0.89]; regularly active: 0.84 [0.75–0.94]), heart failure (concentrated activity: 0.60 [0.52–0.70]; regularly active: 0.61 [0.50–0.73]), and stroke (concentrated activity: 0.79 [0.66–0.94]; regularly active: 0.81 [0.65–1.00]).

Concentrated MVPA over 1–2 days (the concentrated activity pattern) was associated with reduced CVD risk in individuals with overweight or obesity, with a magnitude of risk reduction similar to that observed for regularly distributed activity.