Little is known about physical activity in adults at differing risk of cardiovascular disease (CVD). Here, we describe and compare the physical activity and patterns of association with physical activity by CVD risk status based on data from computer-assisted telephone interviews of 2002 men and women aged 50Á70 years in Germany. Physical activity preferences, settings, and health-related attitudes were assessed and groups were compared using chi-square and nonparametric tests. Stratified multi-variable regression models identified factors associated with regular physical activity (at least once a week for 6 months). The proportion of respondents engaging in regular physical activity ranged from 53.8% to 60.6% across the groups (P 00.08). Respondents with and without CVD/CVD risk factors varied modestly regarding the type and settings for physical activity. However, models stratified by CVD risk demonstrated different patterns of association with regular physical activity. Socioeconomic status, for example, was important for respondents with CVD-related risk factors (odds ratio 02.30; 95%CI: 1.38 to 3.85 for high vs. low socioeconomic status), while internal health locus of control and other attitudes towards physical activity were important for respondents with CVD (odds ratio 01.20; 95%CI: 1.06 to 1.35 per unit increase at subscale score). Our data provide opportunities for developing physical activity interventions targeted at individuals with differing cardiovascular risk.