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Eur Heart J. 2019 Nov 8. pii: ehz768. doi: 10.1093/eurheartj/ehz768. [Epub ahead of print]

Changes in exercise frequency and cardiovascular outcomes in older adults.

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Department of Biomedical Sciences, Seoul National University Graduate School, Biomedical Science Building 117, 103 Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Department of Family Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongro-gu, Seoul 03080, Republic of Korea.
Department of Family Medicine and Community Health, Duke University School of Medicine, 2100 Erwin Rd, Durham, NC 27705, USA.
JW Lee Center for Global and Office of Health Society and Education, Seoul National University College of Medicine, 71 Ihwajang-gil, Jongno-gu, Seoul 03087, Republic of Korea.



Little is known about the association of changes in moderate to vigorous physical activity (MVPA) level with cardiovascular disease (CVD), especially in older adults whose ability to engage in frequent MVPA naturally wanes as they age. We aimed to examine the association of changes in MVPA and CVD in older adults.


In a nationwide cohort study of older adults aged 60 years or older, we identified more than 1.1 million subjects without previous history of CVD at baseline who underwent two consecutive national health screening from 2009 to 2012. We prospectively assessed the risk of CVD occurred between 2013 and 2016 according to changes in frequency of MVPA by initial MVPA status. Compared to those who were continuously physically inactive, those who increased their frequency of MVPA from physically inactive to 1-2 times per week [0.7/1000 person-years (PY) decrease in incidence rate (IR); adjusted hazard ratio (aHR) 0.95; 95% confidence interval (CI) 0.92-0.99], 3-4 times per week (1.5/1000 PY decrease in IR; aHR 0.89; 95% CI 0.84-0.94), ≥5 times per week (0.4/1000 PY decrease in IR; aHR 0.91; 95% CI 0.85-0.97) had a significantly reduced risk for total CVD (P for trend <0.001). Older adults who became physically inactive from engaging in more than 1-2 times of MVPA per week had a higher CVD risk compared to those who maintained their frequency of MVPA.


Among older adults, engaging in higher frequency of MVPA or maintaining MVPA level was associated with reduced risk of CVD.


Cardiovascular diseases; Exercise; Health behaviour; Older adults


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