A large study has found that adults who later develop heart disease start to become less physically active about 12 years before their diagnosis.
This decline in physical activity continues after the heart problem occurs, and people remain less active than their healthy peers for many years.
Being physically active is important for both preventing and managing heart disease. Yet, many adults do not get enough moderate to vigorous exercise. There are also big differences between groups of people when it comes to staying active throughout life.
The research was part of the CARDIA study (Coronary Artery Risk Development in Young Adults) and was published in JAMA Cardiology. It involved scientists from several institutions, including the U.S. National Heart, Lung, and Blood Institute and universities in the United States and Israel.
The study followed 3,068 adults over several decades—starting in 1985 and continuing until 2022. Participants lived in four U.S. cities and were tracked for about 34 years on average. During that time, they completed up to 10 surveys about their physical activity levels. These surveys asked about different types of exercise they had done in the past year.
The researchers focused on moderate to vigorous physical activity, which they measured in “exercise units.” About 300 exercise units equals 150 minutes of physical activity per week, which is the amount recommended in national guidelines.
The study looked at how physical activity levels changed throughout life and how they were affected before and after people developed heart disease. Heart disease included heart attacks, strokes, and heart failure. Medical records were used to confirm these events.
Across the entire group, physical activity levels generally dropped from young adulthood to middle age and then stayed about the same in later years.
However, there were differences between demographic groups. Black women reported the lowest activity levels across all age groups.
Black men showed a more steady decline. White men started with high activity, had a decline, and then showed a slight increase later in life. White women started lower than men but showed a strong recovery in midlife.
The researchers closely examined 236 people who developed heart disease and compared them to similar people who stayed healthy. They found that activity levels started dropping about 12 years before the heart event. The drop became faster in the two years before diagnosis.
People who developed heart failure had the biggest drop in activity before diagnosis. Those who had a heart attack or stroke had slower declines. After diagnosis, everyone stayed at low activity levels, no matter what kind of heart condition they had. On average, they stayed below the recommended 300 exercise units per week.
Even after adjusting for activity levels before diagnosis, people with heart disease were much more likely to stay inactive afterward.
The risk was especially high for Black women, who were more than four times as likely to be inactive compared to healthy peers. White men did not show a higher risk of inactivity after diagnosis.
The researchers concluded that staying active throughout life is important. They emphasized that certain groups, such as Black women, may need extra support to maintain physical activity. By staying active, people may be able to lower their risk of developing heart problems and recover better if they do.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and Vitamin K2 could help reduce heart disease risk.
For more information about heart health, please see recent studies about how to remove plaques that cause heart attacks, and results showing a new way to prevent heart attacks, strokes.
The study is published in JAMA Cardiology.
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