Heart disease linked to less physical activity 12 years before onset

Evan Walker
Evan Walker TheMediTary.Com |
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A decline in physical activity may signal future heart disease years before symptoms begin, according to new research. Thomas Barwick/Getty Images
  • Several lifestyle changes can help lower the risk for heart disease, including being physically active.
  • A new study found that adults who developed heart disease later in life experienced a decline in their physical activity about 12 years before their cardiovascular event.
  • Scientists also discovered that Black male participants had a more continuous decline in physical activity from young adulthood to middle age, and Black female participants consistently reported the lowest physical activity throughout adulthood, highlighting disparity.

According to the World Health Organization (WHO), cardiovascular diseases are currently the leading cause of death worldwide, with about 17.9 million people dying from one each year.

Previous research tells us there are several lifestyle changes we can make to help lower our risk for heart disease, including eating a healthy diet, quitting smoking, getting enough quality sleep, maintaining a healthy weight, managing stress, and being physically active.

“Cardiovascular disease is largely preventable through lifestyle modifications, and physical activity is one of the most powerful tools we have,” Yariv Gerber, PhD, professor in the Department of Epidemiology and Preventive Medicine at the School of Public Health, Gray Faculty of Medical and Health Sciences at Tel Aviv University, Israel, told Medical News Today.

“Lifelong physical activity is essential for maintaining function, preventing disability, and reducing the risk of cardiovascular and metabolic diseases. However, staying active over time can be difficult, especially during life transitions or after health events — periods when people are most vulnerable to decline,” Gerber said.

He is one of the authors of a new study published in the journal JAMA Cardiology, which found that adults who developed heart disease later in life experienced a decline in their physical activity about 12 years before their cardiovascular event.

For this study, researchers analyzed health data from more than 3,000 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study. The study started in 1985-1986 and study participants were given 10 physical activity assessments until 2020-2022.

“While not every individual declined, on average, all demographic groups showed reductions in physical activity from young adulthood through midlife,” Gerber said.

“This highlights how difficult it is to maintain healthy behaviors over time, even among generally healthy adults. Since physical activity is so closely tied to cardiovascular and overall health, it’s essential to recognize when these declines occur — and to intervene early, ideally before habits become ingrained or health starts to deteriorate,” he noted.

And when looking at participants by ethnicity, researchers found that Black male participants had a more continuous decline in physical activity from young adulthood to middle age, and Black female participants consistently reported the lowest physical activity throughout adulthood.

“Addressing this requires culturally tailored strategies, including easy access to safe recreational spaces, affordable facilities, transportation support, and system-level efforts to make physical activity more accessible to all,” he continued. “Integrating physical activity promotion into routine care is also critical; even brief counseling has been shown to increase activity levels, despite the time constraints often cited by providers.”

Fialkow commented this was an interesting review of a population correlating maintaining moderate to intense physical activity to gender, race, and age, with some components showing declines in people who develop cardiac disease.

“We are aware of the benefits of moderate-intense physical activity for cardiac and metabolic health,” he continued. “To better understand populations at risk for achieving these benefits, we can better target them for education and support. Limitations in the study exist, but ultimately, we may be able to find other determinants in social, financial, behavioral, and lifestyle elements that may contribute to obstacles to more intense and regular physical activity, so we can address them.”

MNT also talked to Jennifer Wong, MD, a board certified cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, about this research, who said it was useful to see the timing of physical activity decline and cardiovascular events.

“This underscores the importance of physical activity for preventing cardiovascular disease,” Wong explained. “Prevention is key for our cardiovascular health. I find it helpful to look at the impact of modifiable risk factors and prioritize the more effective strategies.”

“I would like a better understanding of why the decline in physical activity is associated with increased cardiovascular events,” she continued. “Did the decline occur because of progression of cardiovascular disease? Did symptoms of coronary ischemia or heart failure lead to the decline in activity? Or did the decrease in physical activity lead to more cardiovascular disease?”

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