Physical activity from young adulthood to middle age and premature cardiovascular disease events: a 30-year population-based cohort study

Abstract

Background Although physical activity is generally protective of cardiovascular disease (CVD), less is known about how young adult physical activity relates to premature CVD events. The objective of this study was to determine the association between level and change in physical activity from young adulthood to middle age and incidence of premature CVD events before age 60. Methods We analyzed data collected across four urban sites from nine visits over 30 years of follow-up (1985–2016) from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort study of 5115 Black and White women and men aged 18–30 years at baseline (1985–1986). Linear mixed models were used to develop individualized moderate-to-vigorous intensity self-reported physical activity trajectories per participant. Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome. Results Overall, physical activity declined in young adults as they progressed through middle age. Lower physical activity scores (per 100 exercise units) in 18 year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02–1.28), heart failure (AOR 1.21, 95% CI 1.05–1.38), stroke (AOR 1.20, 95% CI 1.04–1.39), and any CVD (AOR 1.15, 95% CI 1.06–1.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02–1.13), stroke (1.06, 95% CI 1.00–1.13), and CVD (1.04, 95% CI 1.01–1.07) events. Meeting the minimum (AOR 0.74, 95% CI 0.0.57–0.96) and twice the minimum (AOR 0.55, 95% CI 0.34–0.91) Department of Health and Human Services physical activity guidelines through follow up was protective of premature CVD events. Conclusions Given recent trends in declining physical activity with age and associated premature CVD events, the transition from young adult to midlife is an important time period to promote physical activity.

Evaluating knowledge, attitude, and physical activity levels related to cardiovascular disease in Egyptian adults with and without cardiovascular disease: a community-based cross-sectional study

“…Frequent engagement in aerobic exercise, such as running, cycling, swimming, or fast walking, has been demonstrated to reduce the risk of cardiovascular disease (CVD)-related illnesses, including stroke. Improvements in blood pressure, lipid profiles, insulin sensitivity, vascular function, and general cardiovascular fitness are among the factors underpinning this protective impact [33][34][35][36][37].…”

Physical Activity Over the Lifecourse and Cardiovascular Disease

“…106 A report from the CARDIA study did not demonstrate differences between physical activity and premature CVD events across sex. 90 A large meta-analysis including 33 studies on >500 000 individuals, demonstrated sex-specific differences between physical activity and the risk of CHD, with women having greater benefits than men. 107 Overall, while the magnitude of benefit may vary by race or sex, the directionality of benefit is likely consistent across race and sex.…”

“…Finally, recent evidence in CARDIA highlights the importance of young adulthood physical activity and cardiorespiratory fitness levels to reduce long-term risk of premature death and fatal and nonfatal cardiovascular events. 90,91…”

“…Analyses from ARIC and CARDIA observed no interaction by race (Black and White) on the association between physical activity and lower incidence of CVD, with a similar association seen in both races. 90,104 Regarding differences by sex, physical activity was associated with reduced all-cause and CVD-attributable death in the FHS (Framingham Heart Study), but a reduction in incident CVD was only observed in men raising the question of whether there are sex-specific differences in risk factor modification and development of disease. 105 A later study from FHS utilizing a commercial wearable monitor (Apple watch) reported an association between greater physical activity and lower 10-year ASCVD (atherosclerotic cardiovascular disease) risk in a sample of mostly women.…”

Assessing the impact of message relevance and frequency on physical activity change: A secondary data analysis from the random AIM trial

“…Physical activity in young adulthood can reduce the risk for cardiovascular disease in later life. 1 , 2 However, less than half of all adults attain the recommended aerobic physical activity level. 3 Young adults have widely adopted mobile and wearable technologies that can be used to deliver digital messages to prompt or motivate physical activity.…”