A recent study has revealed that adults who later develop cardiovascular disease experience a significant decline in physical activity levels starting approximately 12 years before their diagnosis. This trend persists long after the onset of the disease, highlighting the critical role physical activity plays in both preventing and managing cardiovascular conditions.
According to research published in JAMA Cardiology, a multi-institutional team led by scientists from the Coronary Artery Risk Development in Young Adults (CARDIA) study analyzed data from 3,068 participants. This comprehensive analysis tracked physical activity trajectories over nearly four decades, from the study’s initiation in 1985-1986 until 2022. The team included experts from the National Heart, Lung, and Blood Institute, the University of Alabama at Birmingham, the University of Minnesota, Northwestern University, Kaiser Permanente Northern California, and Tel Aviv University.
The study employed both longitudinal and nested case-control analyses to evaluate changes in moderate to vigorous-intensity physical activity across adulthood. Participants were followed in four US cities, with a median follow-up period of 34 years. Researchers measured physical activity using exercise units, where 300 exercise units correspond to approximately 150 minutes of activity per week, consistent with recommended guidelines.
The findings indicate that physical activity levels began to decline steadily from young adulthood into middle age, after which levels stabilized across the cohort. Notably, demographic differences were observed. Black men exhibited a more sustained decline in activity, while Black women consistently reported the lowest levels throughout adulthood. In contrast, white men experienced an initial drop followed by stabilization and some recovery, whereas white women started with lower activity levels but showed notable recovery starting in midlife.
A detailed analysis of 236 cases of incident cardiovascular disease, matched with control participants, revealed significant patterns surrounding heart events. Activity levels among those who later developed cardiovascular disease began to decline around 12 years prior to diagnosis, with the most pronounced accelerations occurring within two years of the event. Participants developing heart failure displayed the steepest pre-event declines, while those who experienced coronary heart disease or stroke showed more gradual reductions.
After diagnosis, all three disease categories maintained similarly low physical activity levels, remaining below the threshold of 300 exercise units. Importantly, cases were found to be more likely than controls to display low activity levels post-diagnosis, with an odds ratio of 1.78. Black women faced the highest risk of low post-cardiovascular disease activity, with an odds ratio of 4.52, while white men showed no significant increase in risk.
The researchers concluded that physical activity declines significantly from early adulthood to midlife, with notable demographic variations. The pronounced declines observed prior to cardiovascular disease events support a strong link between physical activity and health outcomes. Sustaining physical activity throughout life, particularly for vulnerable groups such as Black women, may help lower cardiovascular risk and enhance recovery prospects.
This research highlights the importance of maintaining an active lifestyle and suggests that targeted interventions to promote physical activity among at-risk populations could be beneficial in reducing the prevalence of cardiovascular disease.
