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20 minutes of daily exercise on May 70 is best to protect against serious heart disease in late adulthood

Any physical activity is better late than never, but earlier in old age, even better.

Twenty minutes of daily moderate and vigorous exercise in early adulthood (70-75) can best prevent serious heart disease, including heart failure, in old age (80+), according to research published online in the journal. Hearts.

The findings confirm the maxim “better late than never” when it comes to exercise, but still better earlier, in older age, concludes an editorial at the link.

It is no secret that physical activity is associated with a lower risk of cardiovascular disease and longer life, regardless of gender and ethnicity, while the benefits increase in tandem with the effort.

But relatively few studies have looked solely at whether exercise in later life can help prevent heart disease and stroke in old age.

To close this knowledge gap, the researchers relied on data from the Progetto Veneto Anziani (ProVA), a study of 3,099 older Italians (65 years and older).

Initial assessments, including a detailed medical history, physical examination, scan, and a series of blood tests, were conducted between 1995 and 1997, with two additional assessments every 4 and 7 years.

At the beginning of the study, women more often than men coexisted 4+ conditions, with a higher prevalence of osteoarthritis, osteoporosis and chronic kidney disease; Chronic obstructive pulmonary disease (COPD) and diabetes were more common among men.

Participants filled out questionnaires about levels of physical activity at each time point. Moderate physical activity included walking, bowling, and fishing, while vigorous physical activity included gardening, gym workouts, cycling, dancing, and swimming.

Those whose physical activity was up to 20 or more minutes per day were identified as active; those with less acceleration were identified as inactive. Men were more prone to physical activity than women.

Changes in models of physical activity were defined as: stable-low (inactive-inactive); antipyretic (active-inactive); low-growing (inactive-active); and stable-high (active-active).

Other potentially key background information on household income, educational attainment, number of family members, and smoking and alcohol use was also collected.

Until the end of December 2018, the health of all participants was monitored through links to hospital discharges and death certificates. The final analysis included 2754 participants with complete data, of which 1398 were women (60%).

During the monitoring period, 1,037 new diagnoses of heart disease, heart failure and stroke were made.

Increasing levels of physical activity as well as maintaining an active lifestyle over time have been associated with a reduced risk of cardiovascular disease and death in both men and women.

The greatest reduction in risk was observed in new cases of coronary heart disease and heart failure in late adulthood. There was no significant association between physical activity and stroke.

Most participants had a stable regime of active physical activity for a long time. Samples of stable-high physical activity were associated with a significantly (52%) lower risk of cardiovascular disease among men compared with stable-low types.

The biggest benefits seemed to occur at age 70. The risk was only slightly lower at age 75 and no less at age 80-85, suggesting that improved physical activity earlier in adulthood may have the greatest impact on, say, researchers.

There was also a J-shaped curve of exercise duration with the sharpest reduction in heart disease and heart failure associated with a period of 20 to 40 minutes of moderate and intense physical activity each day.

Although the observed links were strongest among men, the researchers emphasize: “Women who were more physically active had consistently lower rates of disease for almost all cardiovascular outcomes, despite a reduction in the risk did not reach statistical significance, but given the overall mortality the risks were significantly reduced ”.

This is an observational study, and therefore cannot establish the cause. The researchers acknowledged that the study was based on participants’ recollections that physical activity levels were assessed subjectively and that there were no data on mid-life physical activity levels that could affect cardiovascular risk profiles at a later age.

However, they conclude: “These results suggest that public health policy should aim to encourage or initiate physical activity in mid- and early-late age, given the likely greater effectiveness in reducing cardiovascular risk.

“At least 20 minutes of moderate and intense physical activity a day should be recommended to achieve the greatest benefit to the cardiovascular system.”

In a related editorial, Dr. Enrico Fabrice and Gianfranco Sinogra of the University of Trieste, Italy, explain that physical activity improves blood flow and can reduce its stickiness and thus blood clots.

“However, the detailed mechanisms by which [physical activity] may reduce risk in the future [cardiovascular disease] remain incomprehensible, ”they say.

“Beneficial effect from [physical activity] it can simply be explained by its ability to slow down the process of atherosclerosis through better control of blood pressure, blood glucose levels and lipid profile ”.

But the results show that “movement is medicine” in old age. Even a small amount [physical activity] can have a beneficial effect in the elderly, but if it is carried out early, not late, “- they conclude.

Reference: “Association of Physical Activity Trajectories with Major Cardiovascular Diseases in the Elderly” Claudio Barbelini Amidei, Catherine Treviso, Matilda Dotto, Eliana Ferroni, Mariano Noale, Stephanie Magee, Maria Chiaro Corti Sergi and Giuse February 14, 2022, Hearts.
DOI: 10.1136 / heartjnl-2021-320013



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