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Published on: March 7, 2019
Impact of Physical Activity on All-Cause Mortality According to Specific Cardiovascular Disease
Moon-Hyun Kim1, Jung-Hoon Sung2, Moo-Nyun Jin3
1Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Insights
Regular physical activity (PA) significantly reduces all-cause mortality in older adults with cardiovascular disease (CVD). Engaging in PA offers greater survival benefits for individuals with stroke or heart failure compared to those without CVD.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiovascular disease (CVD) is linked to increased mortality and decreased physical activity (PA) in older adults.
- Older adults with CVD often experience reduced physical activity levels.
- Understanding the impact of PA on mortality in this demographic is crucial.
Purpose of the Study:
- To investigate the association between physical activity and all-cause mortality in older adults.
- To evaluate the differential effects of PA on mortality in individuals with and without cardiovascular disease.
- To examine the impact of PA on mortality within specific types of cardiovascular conditions.
Main Methods:
- A cohort of 68,223 participants aged ≥65 years was analyzed.
- Data were sourced from the Korean National Health Insurance Service of Korea-Senior database (2005-2012).
- Cardiovascular disease was defined by a history of specific conditions including stroke, heart failure, and myocardial infarction.
Main Results:
- Physically active groups, both with and without CVD, exhibited lower all-cause mortality compared to sedentary individuals.
- A 500 MET-min/week increase in PA correlated with an 11% reduction in mortality risk for non-CVD and 16% for CVD groups.
- Mortality risk reduction with increased PA was progressive for heart failure and myocardial infarction, plateaued for stroke and peripheral artery disease, but was significantly greater for stroke and heart failure patients.
Conclusions:
- Physical activity is associated with reduced all-cause mortality in older adults, irrespective of cardiovascular disease status.
- The mortality benefits of physical activity are more pronounced in patients with cardiovascular disease, particularly those with stroke or heart failure.
- Promoting physical activity is recommended for older adults with and without CVD to improve survival.
Background:
Patients with cardiovascular disease (CVD) tend to have higher mortality rates and reduced physical activity (PA). We aimed to evaluate the effect of PA on mortality in older adults with specific CVD.
Methods:
We enrolled 68,223 participants (n = 23,871 with CVD, n = 44,352 without CVD) aged ≥65 years with available physical activity data between 2005 and 2012 from the Korean National Health Insurance Service of Korea-Senior database. CVD was defined as a history of ischemic stroke, transient ischemic attack, heart failure, myocardial infarction, and peripheral artery disease.
Results:
Patients with CVD were older than those without CVD. Compared with the sedentary group, the physically active groups with and without CVD had a lower incidence and risk of all-cause death during a median follow up period of 42 (interquartile range 30-51) months. A 500 metabolic equivalent task-min/week increase in PA resulted in an 11% and 16% reduction in the risk of mortality in the non-CVD and CVD groups, respectively. With regard to specific CVDs, the risk of mortality progressively reduced with increasing PA in patients with heart failure or myocardial infarction. However, the reduction reached a plateau in patients with stroke or peripheral artery disease, but was significantly greater in patients with stroke (20% vs. without stoke, 11%, Pint = 0.006) or heart failure (13% vs. without heart failure, 11%; Pint = 0.045).
Conclusions:
PA was associated with a reduced risk of all-cause mortality in older adults with and without CVD. The benefits of PA in patients with CVD, especially patients with stroke or heart failure, were greater than those without.
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