Physical Activity and Risk of Coronary Heart Disease and Stroke in Older Adults: The Cardiovascular Health Study
Background—While guidelines suggest that older adults engage in regular physical activity (PA) to reduce cardiovascular disease (CVD), surprisingly few studies have evaluated this relationship, especially in those older than 75 years. Additionally, with advancing age the ability to perform some types of PA might decrease, making light-moderate exercise such as walking especially important to meet recommendations.
Methods and Results—Prospective cohort analysis among 4207 US men and women of mean age 73 years (SD=6) who were free of CVD at baseline in the Cardiovascular Health Study and followed from 1989 to 1999. PA was assessed and cumulatively updated over time to minimize misclassification and assess long-term effects of habitual activity. Walking (pace, blocks, combined walking score) was updated annually from baseline through 1999. Leisure-time activity and exercise intensity were updated at baseline, 1992, and 1996. Incident CVD (fatal or nonfatal myocardial infarction, coronary death, or stroke) was adjudicated using medical records. During 41 995 person-years of follow-up, 1182 CVD events occurred. After multivariable adjustment, greater PA was inversely associated with coronary heart disease (CHD), stroke (especially ischemic stroke), and total CVD, even in those 75 years and older. Walking pace, distance, and overall walking score, leisure-time activity, and exercise intensity were each associated with lower risk. For example, compared with a walking pace under 2 mph, those that habitually walked at a pace above 3 mph had lower risk of CHD (0.50; CI:0.38-0.67), stroke (0.47; CI:033-0.66) and CVD (0.50; CI:0.40-0.62).
Conclusions—These data provide empiric suggestion supporting PA recommendations, in particular walking, to reduce incidence of CVD among older adults.
- Received July 10, 2015.
- Revision received October 20, 2015.
- Accepted October 26, 2015.