Physiological specificity of muscle-strengthening activity: a comparative analysis of associations with arthritis and cardiovascular disease prevalence in U.S. adults (NHIS 2024).

OBJECTIVE

Physical activity guidelines recommend both aerobic physical activity (APA) and muscle-strengthening activity (MSA) for chronic disease prevention. MSA benefits musculoskeletal health, whereas APA supports cardiovascular health, but epidemiological studies seldom separate MSA-specific associations from those of APA. We examined whether MSA relates more strongly to arthritis than to cardiovascular disease (CVD).

METHODS

We analyzed 31,238 non-institutionalized U.S. adults from the 2024 National Health Interview Survey in a cross-sectional design. Outcomes were self-reported physician diagnoses of arthritis and CVD. We fitted separate survey-weighted logistic regression models for arthritis and CVD, adjusting for APA, age, sex, race/ethnicity, body mass index, and smoking.

RESULTS

Each additional MSA day per week was associated with lower arthritis prevalence (adjusted odds ratio [OR] 0.92, 95% confidence interval [CI] 0.88-0.96). No association was observed for CVD (OR 0.98, 95% CI 0.92-1.04). The formal comparison indicated a significantly stronger association of MSA with arthritis than with CVD (P = 0.027).

CONCLUSIONS

MSA was associated with lower arthritis prevalence but not with CVD, despite adjustment for APA and major confounders. These findings are compatible with more salient musculoskeletal than cardiovascular benefits of MSA. Promoting MSA alongside aerobic activity may support joint health and functional mobility across adulthood.