Exercise has massive benefits for over-65s with CVD risk

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YogaWEBModerate physical activity is associated with a greater than 50% reduction in cardiovascular death (CVD) in over-65s, according to the 12-year National FINRISK Study.

The research, presented at ESC Congress 2016, is a. study in nearly 2,500 adults aged 65 to 74 years found that moderate physical activity reduced the risk of an acute cardiovascular event by more than 30%. High levels of physical activity led to greater risk reductions.

“The role of physical activity in preventing cardiovascular disease (CVD) in people of working age is well established,” said Professor Riitta Antikainen, professor of geriatrics at the University of Oulu, Finland. “But relatively little is known about the effect of regular physical activity on CVD risk in older people.”

The present study assessed the association between leisure time physical activity and CVD risk and mortality in 2,456 men and women aged 65 to 74 years who were enrolled into the National FINRISK Study between 1997 and 2007.
Baseline data collection included self-administered questionnaires on physical activity and other health related behaviour, clinical measurements (blood pressure, weight and height), and laboratory measurements including serum cholesterol. Participants were followed up until the end of 2013. Deaths were recorded from the National Causes of Death Register and incident CVD events (coronary heart disease and stroke) were collected from the National Hospital Discharge Register.

The researchers classified self-reported physical activity as: low: reading, watching TV or working in the household without much physical activity; moderate: walking, cycling or practising other forms of light exercise (fishing, gardening, hunting) at least four hours per week; high: recreational sports (for example running, jogging, skiing, gymnastics, swimming, ball games or heavy gardening) or intense training or sports competitions at least three hours a week.

During a median follow-up of 11.8 years, 197 participants died from CVD and 416 had a first CVD event.

When the researchers assessed the link between physical activity and outcome they adjusted for other cardiovascular risk factors (blood pressure, smoking and cholesterol) and social factors (marital status and education). To minimise reverse causality, where worse health leads to less physical activity, patients with coronary heart disease, heart failure, cancer, or prior stroke at baseline were excluded from the analysis.

The investigators found that moderate and high leisure time physical activity were associated with a 31% and 45% reduced risk of an acute CVD event, respectively (figure 1). Moderate and high leisure time physical activity were associated with a 54% and 66% reduction in CVD mortality.

Antikainen said: “Our study provides further evidence that older adults who are physically active have a lower risk of coronary heart disease, stroke, and death from cardiovascular disease. The protective effect of leisure time physical activity is dose dependent – in other words, the more you do, the better. Activity is protective even if you have other risk factors for cardiovascular disease such as high cholesterol.”

She concluded: “Physical exercise may become more challenging with ageing. However, it is important for older people to still get enough safe physical activity to stay healthy after their transition to retirement.”

See also other ESC 2016 material:

CVD patients benefit from Mediterranean diet
ICDs increase traffic accident risk by 50%
D-I-Y low cost smartphone app to detect atrial fibrillation
Sudden death in HCM patients rarely associated with exercise

Purpose: The role of physical activity on cardiovascular disease prevention is well established among working age population. Relatively little is known on the effect of regular physical activity on CVD risk among the elderly. We investigated whether leisure time physical activity (LTPA) is independently associated with CVD mortality and CVD incidence in older adults.
Methods: Prospective cohort of 2409 men and women aged 65–74 years who participated in a baseline risk factor survey between 1997 and 2007 in Finland. The study protocol included a self-administered questionnaire, health examination at the study site and blood sample for laboratory analysis. Mortality data were obtained from the National Causes of Death Register and data on incident CVD (coronary heart disease and stroke) events from the National Hospital Discharge Register. The median follow-up time was 11.8 years. Self-reported LTPA was classified into three levels: low, moderate and high.
Results: Age, area, study year and sex adjusted hazard ratios of moderate and high physical activity level, compared to the low level, were 0.42 (0.31–0.58) and 0.29 (0.17–0.49) (p for trend <0.001) for CVD mortality and 0.65 (0.51–0.82) and 0.50 (0.35–0.71) (<0.001) for an incident CVD event, respectively. Multifactorial adjusted (previous model + smoking, body mass index, systolic blood pressure, serum total cholesterol, education and marital status) hazard ratios were 0.46 (0.33–0.64) and 0.34 (0.20–0.59) (p for trend <0.001) for CVD mortality and 0.69 (0.54–0.88) and 0.55 (0.38–0.79) (0.002) for an incident CVD event, respectively. Further adjustment for self-reported inability to practice physical activity reduced the protective effect slightly.
Conclusions: Physical activity associates with a reduced risk of CVD mortality and incident CVD events in older adults independently of the major known CVD risk factors. The protective effect of physical activity is dose dependent with a higher level of physical activity showing a stronger association.

P Jousilahti, N Barengo, R Antikainen, K Borodulin, K Harald

ESC Congress 2016 material
ESC Congress 2016 abstract


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