Introduction:
Maintenance of physical activity during later life is associated with reduced risk of cardiovascular disease; however, how long-term trajectories of physical activity into old age are associated with established and novel cardiovascular disease risk factors remains unclear. This study examined the association between 20-year physical activity trajectories and a wide range of cardiovascular disease biomarkers in early old age.
Hypothesis:
We assessed the hypothesis that persistent long-term physical activity from midlife to old age is associated with the lowest levels of cardiovascular disease risk factors in old age.
Methods:
7735 men (mean baseline age 50.2 ± 5.8 years) recruited in 1978-80 were followed up after 12, 16 and 20 years, reporting habitual physical activity levels at each wave. At the 20-year follow up, surviving men also attended a physical examination and provided a fasting blood sample. Initially, group-based trajectory modelling was used to identify the trajectories of physical activity. Then regression analyses were used to examine the association between trajectory group membership and a number of cardiometabolic, cardiac and inflammatory markers. Analyses were adjusted for a range of sociodemographic, health and lifestyle factors and use of blood pressure-lowering and antihypertensive drugs.
Results:
A total of 3228 men providing physical activity data at ≥3 time points with cardiovascular biomarker data were included in the analysis. Three distinct 20-year trajectories were identified: low decreasing (20.1%), light stable (52.7%) and moderate increasing (27.2%). In comparison to the low decreasing group, membership of the light stable and moderate increasing physical activity trajectory groups was associated with a more favourable cardiometabolic profile, including lower HbA1C and insulin; lower levels of inflammation, including lower levels of interleukin 6 and C-reactive protein; and lower levels of the cardiac marker high-sensitivity troponin T. The magnitude of the associations was similar for the light stable and moderate increasing groups.
Conclusion:
In conclusion, twenty-year trajectories of physical activity from midlife to old age were associated with established and novel cardiovascular disease risk factors. Effect sizes were similar for members following a light stable and a moderate increasing physical activity trajectory, suggesting that even relatively light but persistent physical activity into old age can be a determinant of lower cardiovascular disease risk.
Relation of diet to cardiovascular disease risk factors in subjects with cardiovascular disease in Australia and New Zealand: analysis of the Long-Term Intervention with Pravastatin in Ischaemic Disease trial