Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality.

Aggio, D; Papachristou, E; Papacosta, O; Lennon, LT; Ash, S; Whincup, P; Wannamethee, SG; Jefferis, BJ (2020) Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality. J Epidemiol Community Health, 74 (2). pp. 130-136. ISSN 1470-2738
SGUL Authors: Whincup, Peter Hynes

PDF Published Version
Available under License Creative Commons Attribution.

Download (350kB) | Preview


INTRODUCTION: It is well established that physical activity (PA) protects against mortality and morbidity, but how long-term patterns of PA are associated with mortality and cardiovascular disease (CVD) remains unclear. METHODS: 3231 men recruited to the British Regional Heart Study, a prospective cohort study, reported usual PA levels at baseline in 1978-1980 (aged 40-59 years) and at 12-year, 16-year and 20-year follow ups. Twenty-year trajectories of PA, spanning from 1978/1980 to 2000, were identified using group-based trajectory modelling. Men were subsequently followed up until 30 June 2016 for mortality through National Health Service central registers and for non-fatal CVD events through primary and secondary care records. Data analyses were conducted in 2019. RESULTS: Three PA trajectories were identified: low/decreasing (22.7%), light/stable (51.0%) and moderate/increasing (26.3%). Over a median follow-up of 16.4 years, there were 1735 deaths. Compared with the low/decreasing group, membership of the light/stable (HR 0.83, 95% CI 0.74 to 0.94) and moderate/increasing (HR 0.76, 95% CI 0.66 to 0.88) groups was associated with a lower risk of all-cause mortality. Similar associations were observed for CVD mortality, major coronary heart disease and all CVD events. Associations were only partially explained by a range of confounders. Sensitivity analyses suggested that survival benefits were largely driven by most recent/current PA. CONCLUSIONS: A dose-response relationship was observed, with higher levels of PA from midlife to old age associated with additional benefits. However, even fairly modest and sustained PA was protective and may be more achievable for the most inactive.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:
Keywords: CHD/coronorary heart, ageing, cardiovascular disease, life course epidemiology, physical activity, 1117 Public Health And Health Services, 1604 Human Geography, Epidemiology
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: J Epidemiol Community Health
ISSN: 1470-2738
Language: eng
9 January 2020Published
8 November 2019Published Online
19 October 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Project IDFunderFunder ID
FS/15/70/32044British Heart Foundation
2010–03–023National Institute for Health Research
PG/13/86/30546British Heart Foundation
RG/13/16/30528British Heart Foundation
PubMed ID: 31704805
Go to PubMed abstract
Publisher's version:

Actions (login required)

Edit Item Edit Item