• Aortic Diseases

The benefits of regular exercise for prevention of cardiovascular disease (CVD) are well known. However, most of the evidence is derived from population-based studies of relatively healthy patients; data on exercise after a cardiovascular event is less robust, particularly in older patients. Kang and colleagues1 hypothesised that regular exercise in older adults with CVD would be associated with lower morbidity and mortality. In a series of 6076 older adults (age at least 60 years with a mean age of 72 years, 51% men) with a new diagnosis of CVD in the Korean National Health Insurance Senior database, levels of physical activity were assessed by a validated questionnaire completed within 2 years before and after the cardiovascular event. Over a median follow-up of 3.8 years, the incidence rate (IR) for overall mortality was lower in patients who exercised regularly both before and after the incident event (IR 2.9, HR 0.53, 95% CI 0.38 to 0.73) and in those who began exercise after the event (IR 3.5, HR 0.73, 95% CI 0.58 to 0.91) compared with non-exercisers (IR 4.8 per 100 person-years) (figure 1). Although the magnitude was attenuated, benefit still was seen in patients age 75 and older, compared with those age 60–75 years.

In the accompanying editorial, Barbiellini Amidei2 discuss how physical activity trajectories in early to mid-life and then late in life might …