title: Physical Activity and Risk of Coronary Heart Disease and Stroke in Older Adults: The Cardiovascular Health Study.
abstract: BACKGROUND
  Although guidelines suggest that older adults engage in regular physical activity (PA) to reduce cardiovascular disease (CVD), surprisingly few studies have evaluated this relationship, especially in those >75 years. In addition, with advancing age the ability to perform some types of PA might decrease, making light-moderate exercise such as walking especially important to meet recommendations.
  
  
  RESULTS
  Prospective cohort analysis among 4207 US men and women of a mean age of 73 years (standard deviation=6) who were free of CVD at baseline in the Cardiovascular Health Study were followed from 1989 to 1999. PA was assessed and cumulatively updated over time to minimize misclassification and assess the long-term effects of habitual activity. Walking (pace, blocks, combined walking score) was updated annually from baseline through 1999. Leisure-time activity and exercise intensity were updated at baseline, 1992, and 1996. Incident CVD (fatal or nonfatal myocardial infarction, coronary death, or stroke) was adjudicated using medical records. During 41,995 person-years of follow-up, 1182 CVD events occurred. After multivariable adjustment, greater PA was inversely associated with coronary heart disease, stroke (especially ischemic stroke), and total CVD, even in those ≥75 years. Walking pace, distance, and overall walking score, leisure-time activity, and exercise intensity were each associated with lower risk. For example, in comparison with a walking pace <2 mph, those that habitually walked at a pace >3 mph had a lower risk of coronary heart disease (0.50; confidence interval, 0.38-0.67), stroke (0.47; confidence interval, 033-0.66), and CVD (0.50; confidence interval, 0.40-0.62).
  
  
  CONCLUSIONS
  These data provide empirical evidence supporting PA recommendations, in particular, walking, to reduce the incidence of CVD among older adults.
authors.affiliation: From Research Centre in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Portugal (L.S.-M.); Department of Epidemiology, University of Washington, Seattle (D.S.S., B.M.P., W.T.L.); Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle (D.S.S., B.M.P.); New York Academy of Medicine, New York (D.S.S.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); Department of Neurology, University of Washington, Seattle (W.T.L.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.). soaresmiranda@fade.up.pt.
authors.forename: Luisa
authors.initials: L
authors.lastname: Soares-Miranda
authors.affiliation: From Research Centre in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Portugal (L.S.-M.); Department of Epidemiology, University of Washington, Seattle (D.S.S., B.M.P., W.T.L.); Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle (D.S.S., B.M.P.); New York Academy of Medicine, New York (D.S.S.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); Department of Neurology, University of Washington, Seattle (W.T.L.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.affiliation: From Research Centre in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Portugal (L.S.-M.); Department of Epidemiology, University of Washington, Seattle (D.S.S., B.M.P., W.T.L.); Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle (D.S.S., B.M.P.); New York Academy of Medicine, New York (D.S.S.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); Department of Neurology, University of Washington, Seattle (W.T.L.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.affiliation: From Research Centre in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Portugal (L.S.-M.); Department of Epidemiology, University of Washington, Seattle (D.S.S., B.M.P., W.T.L.); Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle (D.S.S., B.M.P.); New York Academy of Medicine, New York (D.S.S.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); Department of Neurology, University of Washington, Seattle (W.T.L.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.affiliation: From Research Centre in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Portugal (L.S.-M.); Department of Epidemiology, University of Washington, Seattle (D.S.S., B.M.P., W.T.L.); Department of Medicine, Cardiovascular Health Research Unit, University of Washington, Seattle (D.S.S., B.M.P.); New York Academy of Medicine, New York (D.S.S.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); Department of Neurology, University of Washington, Seattle (W.T.L.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007899:Leisure Activities; D008297:Male; D009043:Motor Activity; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012494:Sampling Studies; D020521:Stroke / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D016138:Walking
keywords: aged; cardiovascular diseases; exercise; prevention & control