Article Text
Abstract
Introduction Cardiovascular benefits deriving from physical activity are well known, but it is unclear whether physical activity trajectories in late life are associated with different risks of cardiovascular diseases.
Methods Progetto Veneto Anziani (Pro.V.A.) is a cohort study of 3099 Italians aged ≥65 years with baseline assessment in 1995–1997 and follow-up visits at 4 and 7 years. Surveillance was extended to 2018 by linkage with hospital and mortality records. Prevalent and incident cardiovascular diseases (coronary heart disease, heart failure and stroke) were identified through clinical examination, questionnaire, or hospital records. Moderate to vigorous physical activity was considered as a time-varying variable. Physical activity trajectories were categorised as: stable-low, high-decreasing, low-increasing and stable-high. Exposure was also assessed at 70, 75, 80 and 85 years.
Results Overall, physical activity was associated with lower rates of incident cardiovascular diseases. A significant risk reduction was present among men and was stronger earlier in late life (70–75 years). Trajectories of stable-high physical activity were associated with a significantly lower risk of cardiovascular outcomes among men (HR 0.48, 95% CI 0.27 to 0.86) compared with those with stable-low trajectories (p for trend 0.002). No significant association was found with stroke. The greatest cardiovascular risk reduction was observed for >20 min/day of physical activity, and was more marked at 70 years.
Conclusion Increasingly active trajectories of physical activity were associated with lower rates of cardiovascular diseases and overall mortality. Promoting at least 20 min/day of physical activity early in late life seems to provide the greatest cardiovascular benefits.
- epidemiology
- coronary artery disease
- heart failure
- risk factors
- stroke
Data availability statement
No data are available. The data we used for our study cannot be shared publicly. A researcher interested in gaining access to the relevant data should request them from the Regional Epidemiological Service of Veneto Region at ser@azero.veneto.it.
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Data availability statement
No data are available. The data we used for our study cannot be shared publicly. A researcher interested in gaining access to the relevant data should request them from the Regional Epidemiological Service of Veneto Region at ser@azero.veneto.it.
Footnotes
Contributors CBA conceived the study, performed the analyses, interpreted the results and wrote the manuscript, and is guarantor of this paper. CT contributed to the study design, revised the study, interpreted the results, revised the manuscript and provided the data. MD contributed to the study design, revised the study, interpreted the results and provided the data. EF contributed to the study design, revised the study, interpreted the results and revised the manuscript. MN revised the study, contributed to the statistical analyses, interpreted the results and revised the manuscript. SM revised the study, interpreted the results and revised the manuscript. MCC revised the study, revised the manuscript and provided the data. GB revised the study, interpreted the results and revised the manuscript. UF contributed to the study design, revised the study, contributed to the statistical analyses, interpreted the results, revised the manuscript and provided the data. GS revised the study, revised the manuscript and provided the data. All authors read and approved the final version of the manuscript.
Funding The Pro.V.A. study was supported by the Fondazione Cassa di Risparmio di Padova e Rovigo; the University of Padova (Population Ageing - Economics, Health, Retirement and the Welfare State - POPA_EHR); the Veneto Regional Local Health and Social Care Units 15 and 18 (Azienda Unità Locale Socio Sanitaria 15 and 18); and the Veneto Regional Authority (Ricerca Sanitaria Finalizzata n.156/03 and Ricerca Sanitaria Finalizzata RSF-2017–00000533).
Disclaimer The sponsor had no role in the design, methods, subject recruitment, data collections, analysis and preparation of the paper.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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