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Late-life physical activity changes after a cardiovascular event: can we reduce mortality risks?
  1. Claudio Barbiellini Amidei
  1. Epidemiological Department, Azienda Zero, Veneto Region, Italy
  1. Correspondence to Dr Claudio Barbiellini Amidei, Epidemiological Department, Azienda Zero, Veneto Region, Italy; claudioamidei{at}

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Cardiovascular diseases (CVD) are highly prevalent conditions that carry one of the highest morbidity and mortality burdens worldwide.1 Physical activity is a known protective factor for prevention of non-communicable diseases such as CVD, and for all-cause and cardiovascular mortality. Implementing prevention strategies to promote a physically active lifestyle should therefore be a public health priority.

A recent systematic review suggests that patients with coronary heart disease who maintain or engage in physical activity can significantly reduce mortality risks compared to those inactive over time.2 Changes in physical activity describe trajectories that have the potential of better defining individual risk profiles compared to single-time assessments.2 Recently, growing interest has been drawn to the possibility of achieving cardiovascular benefits by engaging in physical activity also in late-life.3 4 For most non-communicable disease risk factors, longer duration of exposure is associated with higher chances of developing the disease. Similarly, if the exposure to a protective factor is too short, this may not exert any relevant beneficial effect. This could be the case of beginning physical activity in late-life. Numerous studies have shown that increasing physical exercise in mid-life is associated with a significantly lower mortality risk, also among patients with CVD,5 6 but evidence in late-life remainsscarce. Given the presence of ageing populations with a high prevalence of CVD, examining this association has great clinical and public health significance.

A new study by Kang and colleagues7 published in this journal suggests that increasing physical exercise habits after an incident cardiovascular event in late-life can significantly reduce mortality risks. The authors selected data from 558 147 individuals, a 10% sample of the 5.5 million people aged ≥60 years present in the Korean National Health Insurance database, and included only those with clinical assessments between 2003 and 2012. Incident CVD was …

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  • Contributors CBA conceived the paper and drafted the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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