The SA Journal Diabetes & Vascular Disease Vol 14 No 2 (December 2017)

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RESEARCH ARTICLE SA JOURNAL OF DIABETES & VASCULAR DISEASE
80 VOLUME 14 NUMBER 2 • DECEMBER 2017
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Any physical activity in elderly better than none at all for reducing
cardiovascular risk
Any physical activity in the elderly is
better than none at all for reducing
cardiovascular risk, according to an
18-year study in more than 24 000
adults published recently in the European
Journal of Preventive Cardiology. ‘We
know that regular physical activity has
major health benefits,’ said first author Dr
Sangeeta Lachman, a cardiologist at the
Academic Medical Centre, Amsterdam,
the Netherlands.
‘Healthy adults are advised to do at
least 150 minutes a week of moderate
intensity or 75 minutes a week of vigorous
intensity aerobic exercise to reduce
their risk of cardiovascular disease,’ she
continued. ‘These recommendations are
based primarily on research in middle-
aged adults and we wanted to know
whether regular physical activity yields
comparable cardiovascular health benefits
in elderly people.’
This study compared the association
between different levels of physical
activity and the risk of cardiovascular
disease in middle-aged to elderly
individuals. The hypothesis was that
exercise would be equally beneficial in
reducing cardiovascular risk in middle-
aged and elderly individuals.
The study included 24 502 adults
aged 39 to 79 years who participated in
the European Prospective Investigation
into Cancer (EPIC) Norfolk cohort, a
prospective population study that is part
of the ten-country collaboration EPIC
study. The cohort was primarily designed
to assess dietary and other determinants
of cancer, but data were also collected on
determinants of cardiovascular disease.
Participants were recruited between
1993 and 1997 from registries of general
practices in the county of Norfolk, UK.
On enrolment into the study, participants
completed a health and lifestyle
questionnaire, underwent a standardised
physical examination and gave blood
samples. Physical activity during work
and leisure time was assessed with a
questionnaire and participants were
categorised as active, moderately active,
moderately inactive and inactive.
Patients were followed up until 31
March 2015 for hospitalisation or death
from cardiovascular events (coronary
heart disease or stroke), which were
identified by linking the participant’s
unique National Health Service number
with the East Norfolk Health Authority
(ENCORE) database.
Physical activity levels and time to
cardiovascular events were investigated
in three age categories: less than 55, 55
to 65 (middle-aged), and over 65 years of
age (elderly).
During a median follow-up of 18
years there were 5 240 cardiovascular
disease events. In elderly participants,
hazard ratios for cardiovascular events
were 0.86, 0.87 and 0.88 in moderately
inactive, moderately active and active
people, respectively, compared to
inactive people. In those aged 55–65 and
less than 55 years, the associations were
directionally similar, but not statistically
significant.
Dr Lachman said: ‘We observed an
inverse association between physical
activity and the risk of cardiovascular
disease in both middle-aged and
elderly people. As expected, there were
more cardiovascular events in elderly
participants, which could explain why
the association only reached significance
in this age category.’
‘Elderly people who were moderately
inactive had a 14% reduced risk of
cardiovascular events compared to those
who were completely inactive,’ continued
Dr Lachman. ‘This suggests that even
modest levels of physical activity are
beneficial to heart health. Elderly people
should be encouraged to at least do
low-intensity physical activities such as
walking, gardening, and housework.’
She concluded: ‘Given our
aging population and the impact of
cardiovascular disease on society, a
broaderarrayofpublichealthprogrammes
is needed to help elderly people engage
in any physical activity of any level and
avoid being completely sedentary.’