ADULTS who go on to develop cardiovascular disease (CVD) experience a marked decline in physical activity levels starting around 12 years before their diagnosis, and this reduction persists long after their cardiac event, according to a new study. The findings suggest a growing gap in activity between those who develop CVD and their healthy peers, underlining the importance of prioritising exercise throughout adulthood.
Researchers from the Coronary Artery Risk Development in Young Adults (CARDIA) study followed 3,068 participants from 1985 to 2022, collecting up to ten self-reported assessments of moderate to vigorous-intensity physical activity (MVPA). Physical activity was measured using exercise units, where 300 units equal roughly 150 minutes per week, which aligns with current guidelines. Physical activity was tracked alongside medical events such as heart failure, coronary heart disease, and stroke. Across the cohort, activity steadily declined from young adulthood into midlife before stabilising. The analysis found that CVD cases began to diverge from controls about 12 years prior to diagnosis, with MVPA dropping off more rapidly. Black men showed a more sustained decline over time, while Black women consistently reported the lowest activity levels of all groups and faced the highest risk of remaining inactive after their CVD event (odds ratio 4.52; 95% CI 2.29–8.89). After a cardiovascular event, all affected participants struggled to regain activity, with overall post-event activity remaining consistently below recommended levels and gaps persisting versus controls.
The study concludes that maintaining physical activity throughout adulthood could be vital for reducing the risk and impact of cardiovascular disease, particularly for Black women and other high-risk groups. Researchers highlight the need for targeted strategies in clinical practice to support physical activity recovery after cardiac events and to address persistent demographic disparities. Early intervention to encourage continued moderate to vigorous activity may help to close these gaps and potentially alter long-term cardiovascular outcomes.
Reference
Gerber Y et al. Trajectories of Physical activity before and after cardiovascular disease events in CARDIA participants. JAMA Cardiol. 2025;DOI:10.1001/jamacardio.2025.2282.
