In the Journals

Modest physical activity lowers CVD risk in older adults

Engaging in even modest physical activity was associated with lower risk for CHD, stroke and CVD in older adults, according to the results of a prospective cohort study.

Researchers analyzed 4,207 older adults (mean age, 73 years; 61% women; 21.7% nonwhite) enrolled in the Cardiovascular Health Study from 1989 to 1999. All participants were free of CVD at baseline.

They assessed and cumulatively updated physical activity over time, including walking pace, walking distance, cumulative walking score, leisure-time activity and exercise intensity. The outcome of interest was incident CVD, defined as fatal or nonfatal MI, coronary death or stroke.

Activity lowered risk

Luisa Soares-Miranda, PhD, and colleagues documented 1,182 CVD events over 41,995 person-years of follow-up.

Compared with participants with a walking pace of less than 2 mph, those with a faster pace had lower risk for CHD (HR for 2-3 mph = 0.66; 95% CI, 0.56-0.78; HR for > 3 mph = 0.5; 95% CI, 0.38-0.67), total stroke (HR for 2-3 mph = 0.7; 95% CI, 0.58-0.85; HR for > 3 mph = 0.47; 95% CI, 0.33-0.66) and total CVD (HR for 2-3 mph = 0.67; 95% CI, 0.59-0.76; HR for > 3 mph = 0.5; 95% CI, 0.4-0.62), the researchers found.

Compared with those who walked 0 to 5 blocks per week, those who walked at least 26 blocks per week had lower risk for CHD (HR for 26-48 blocks = 0.6; 95% CI, 0.47-0.78; HR for ≥ 49 blocks = 0.64; 95% CI, 0.5-0.83), total stroke (HR for 26-48 blocks = 0.51; 95% CI, 0.38-0.67; HR for ≥ 49 blocks = 0.46; 95% CI, 0.35-0.62) and total CVD (HR for 26-48 blocks = 0.56; 95% CI, 0.46-0.68; HR for ≥ 49 blocks = 0.53; 95% CI, 0.44-0.65).

Risk for CHD, total stroke and total CVD declined with improving walking score (P for trend < .001), according to the researchers.

Soares-Miranda and colleagues also stratified participants into quintiles by leisure-time activity as measured by kilocalorie per week. Compared with the lowest quintile, patients in the other four quintiles were at reduced risk for CHD (P for trend = .001), stroke (P for trend = .001) and CVD (P for trend < .001), they found.

Compared with those who performed no exercise, those with low, moderate or high intensity of exercise were all at reduced risk for CHD (P for trend = .001), stroke (P for trend < .001) and CVD (P for trend < .001), they wrote.

Analysis according to stroke type indicated that the associations were present for ischemic stroke but not hemorrhagic stroke, Soares-Miranda, from Research Centre in Physical Activity, Health and Leisure, Faculty of Sport at the University of Porto, Portugal, and colleagues wrote.

Consistent across subgroups

The findings were consistent regardless of sex and age (< 75 years or ≥ 75 years at baseline) and did not change after adjustment for potential confounders such as BP, lipids and C-reactive protein, they wrote.

“Our study of older Americans shows that, even late in life, moderate physical activity such as walking is linked to lower incidence of [CVD],” Soares-Miranda said in a press release. “It appears that whether one increases the total distance or the pace of walking, CVD risk is lowered. Fortunately, walking is an activity that many older adults can enjoy.” – by Erik Swain

Disclosure: The researchers report no relevant financial disclosures.

Engaging in even modest physical activity was associated with lower risk for CHD, stroke and CVD in older adults, according to the results of a prospective cohort study.

Researchers analyzed 4,207 older adults (mean age, 73 years; 61% women; 21.7% nonwhite) enrolled in the Cardiovascular Health Study from 1989 to 1999. All participants were free of CVD at baseline.

They assessed and cumulatively updated physical activity over time, including walking pace, walking distance, cumulative walking score, leisure-time activity and exercise intensity. The outcome of interest was incident CVD, defined as fatal or nonfatal MI, coronary death or stroke.

Activity lowered risk

Luisa Soares-Miranda, PhD, and colleagues documented 1,182 CVD events over 41,995 person-years of follow-up.

Compared with participants with a walking pace of less than 2 mph, those with a faster pace had lower risk for CHD (HR for 2-3 mph = 0.66; 95% CI, 0.56-0.78; HR for > 3 mph = 0.5; 95% CI, 0.38-0.67), total stroke (HR for 2-3 mph = 0.7; 95% CI, 0.58-0.85; HR for > 3 mph = 0.47; 95% CI, 0.33-0.66) and total CVD (HR for 2-3 mph = 0.67; 95% CI, 0.59-0.76; HR for > 3 mph = 0.5; 95% CI, 0.4-0.62), the researchers found.

Compared with those who walked 0 to 5 blocks per week, those who walked at least 26 blocks per week had lower risk for CHD (HR for 26-48 blocks = 0.6; 95% CI, 0.47-0.78; HR for ≥ 49 blocks = 0.64; 95% CI, 0.5-0.83), total stroke (HR for 26-48 blocks = 0.51; 95% CI, 0.38-0.67; HR for ≥ 49 blocks = 0.46; 95% CI, 0.35-0.62) and total CVD (HR for 26-48 blocks = 0.56; 95% CI, 0.46-0.68; HR for ≥ 49 blocks = 0.53; 95% CI, 0.44-0.65).

Risk for CHD, total stroke and total CVD declined with improving walking score (P for trend < .001), according to the researchers.

Soares-Miranda and colleagues also stratified participants into quintiles by leisure-time activity as measured by kilocalorie per week. Compared with the lowest quintile, patients in the other four quintiles were at reduced risk for CHD (P for trend = .001), stroke (P for trend = .001) and CVD (P for trend < .001), they found.

Compared with those who performed no exercise, those with low, moderate or high intensity of exercise were all at reduced risk for CHD (P for trend = .001), stroke (P for trend < .001) and CVD (P for trend < .001), they wrote.

Analysis according to stroke type indicated that the associations were present for ischemic stroke but not hemorrhagic stroke, Soares-Miranda, from Research Centre in Physical Activity, Health and Leisure, Faculty of Sport at the University of Porto, Portugal, and colleagues wrote.

Consistent across subgroups

The findings were consistent regardless of sex and age (< 75 years or ≥ 75 years at baseline) and did not change after adjustment for potential confounders such as BP, lipids and C-reactive protein, they wrote.

“Our study of older Americans shows that, even late in life, moderate physical activity such as walking is linked to lower incidence of [CVD],” Soares-Miranda said in a press release. “It appears that whether one increases the total distance or the pace of walking, CVD risk is lowered. Fortunately, walking is an activity that many older adults can enjoy.” – by Erik Swain

Disclosure: The researchers report no relevant financial disclosures.