Early Decline in Physical Activity Predicts Future Cardiovascular Disease Risk

A comprehensive study involving multiple institutions has revealed that individuals who eventually develop cardiovascular disease (CVD) tend to experience a gradual reduction in physical activity starting approximately 12 years prior to their diagnosis. This decline persists well beyond diagnosis, highlighting the long-term impact of lifestyle on heart health. The research, titled "Trajectories of Physical Activity Before and After Cardiovascular Disease Events in CARDIA Participants," was published in JAMA Cardiology and examined data from over 3,000 adults followed from the mid-1980s through 2022.

Scientists from the US National Heart, Lung, and Blood Institute, University of Alabama at Birmingham, University of Minnesota, Northwestern University, Kaiser Permanente Northern California, and Tel Aviv University collaborated on this project. They used longitudinal and nested case-control analyses to assess how moderate to vigorous physical activity levels changed throughout adulthood, both before and after cardiovascular events such as coronary heart disease, stroke, and heart failure.

Participants’ physical activity was quantified using exercise units, with 300 units approximating the recommended 150 minutes of activity per week. Self-reported data from validated questionnaires indicated a general decline in activity from young adulthood, especially among Black men and women, with Black women consistently reporting the lowest activity levels. White men showed an initial decline with some stabilization and slight recovery in midlife, while white women displayed significant increases starting in midlife.

Importantly, individuals who later experienced cardiovascular events showed a sharp decline in activity roughly 12 years prior to diagnosis, with the decline accelerating within two years of the event. Those who developed heart failure exhibited the steepest pre-event decline, whereas declines for coronary heart disease or stroke occurred more gradually. Post-diagnosis, all groups maintained low activity levels, underscoring the importance of sustained physical activity.

Adjusting for pre-event activity levels, cases were more likely to have low activity post-CVD, with Black women at notably higher risk of persistent inactivity after a cardiovascular event. The findings emphasize that maintaining regular physical activity across the lifespan could be crucial for reducing the risk of developing cardiovascular disease and aiding recovery after diagnosis. Encouraging active lifestyles from early adulthood could help mitigate long-term cardiovascular risks, especially in demographic groups with historically lower activity levels.

This research underscores the importance of consistent physical activity for heart health and suggests targeted interventions could benefit high-risk populations, particularly Black women, to improve health outcomes.