Key result
Lower physical activity scores at age 18 were associated with higher odds of premature cardiovascular disease events (AOR 1.15), while meeting minimum physical activity guidelines through follow-up was protective.
Why the study?
Although physical activity is generally protective against CVD, less is known about how young adult physical activity relates to premature CVD events before age 60.
Does maintaining higher physical activity from young adulthood to middle age prevent premature cardiovascular disease events in a community-based cohort?
Cohort (n=5,114)
Yes
Does maintaining higher physical activity from young adulthood to middle age prevent premature cardiovascular disease events in a community-based cohort?
Odds Ratio: 1.15 (95% CI 1.06–1.24)
p-value: p=<0.001
Maintaining higher physical activity levels from young adulthood into middle age is significantly associated with a reduced risk of premature cardiovascular events before age 60.
Lower young adult physical activity and steeper declines were associated with higher premature CVD odds; leaves open whether life-course interventions reduce events.
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.
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Nagata et al. (2022) conducted a cohort in Premature cardiovascular disease (n=5,114). Physical activity level and trajectory vs. Lower physical activity levels was evaluated on Any premature cardiovascular disease (CVD) events (AOR 1.15, 95% CI 1.06-1.24, p=<0.001). Lower physical activity scores at age 18 were associated with higher odds of premature cardiovascular disease events (AOR 1.15), while meeting minimum physical activity guidelines through follow-up was protective.
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