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Cardiovascular disease is associated with decreased physical activity in the 12 years before the onset of the disease
Last reviewed: 03.08.2025
Physical activity begins to decline 12 years before cardiovascular disease, a 34-year study has found.
An international team of scientists has found that adults who later develop cardiovascular disease (CVD) begin to experience a decline in physical activity about 12 years before their diagnosis. This gap in activity persists after the cardiovascular event. The results are published in JAMA Cardiology.
The study is based on data from the Coronary Artery Risk Development in Young Adults (CARDIA) project, which followed 3,068 participants in the United States from the start of follow-up in 1985–86 until 2022. During this period, up to 10 physical activity measurements were taken per person, and the median follow-up was 34 years.
Key findings:
- Physical activity (moderate and vigorous intensity) declined from young to middle age and then stabilized.
- Black women had the lowest and most consistently low lifetime activity participation, followed by black men.
- White women started out with lower activity levels than white men but showed significant recovery in midlife.
- White males showed a decline in activity followed by stabilization and poor growth in adulthood.
Cardiovascular events and activity:
A total of 236 participants had a history of CVD, including coronary heart disease, stroke, or heart failure. They were matched with a disease-free control group.
- Activity levels began to decline sharply 12 years before the event, with a particularly rapid decline 2 years before diagnosis.
- The steepest decline was seen in people who developed heart failure.
- After the cardiac event, activity levels remained low in all three groups (
- Even after adjusting for previous activity level, post-CVD patients were 1.78 times more likely to have low activity levels than controls.
- Black women had the highest risk of low activity after CVD (OR = 4.52), while white men had the lowest (OR = 0.92).
Practical conclusions:
- Physical activity may serve as an early marker of CVD risk, especially if it begins to decline a decade before the disease.
- Developing programs that promote lifelong activity, particularly among vulnerable groups (particularly black women), may reduce cardiovascular risk and improve recovery from illness.
The study highlights the importance of ongoing monitoring of physical activity as a preventive measure and argues for the integration of activity support programmes into the healthcare system.