Physical Activity Alone Could Reduce Cardiovascular Disease Risks

Increasing physical activity may be able to offset the risks of obesity on cardiovascular disease among middle-age and elderly individuals, according to a study published by the European Journal of Preventive Cardiology.

"Overweight and obesity is associated with a higher risk of cardiovascular disease and it is recommended to lose weight," said author Klodian Dhana, PhD. "But in the elderly this is slightly different because weight loss, especially unintentional, is associated with muscle loss and death."

It is well known that regular exercise can prevent serious, chronic diseases, such as cancer, diabetes, and heart disease. Exercise can also increase muscle tone and reduce fat, which can improve overall health.

"Physical activity is associated with a lower risk of cardiovascular disease regardless of age," Dr Dhana said. "We investigated the combined impact of body mass index (BMI) and physical activity on cardiovascular disease in the middle age to elderly population."

Included in the study were 5344 individuals aged 55 and older, with a follow-up of 15 years. Patients also participated in the Rotterdam Study, and did not have cardiovascular disease at baseline.

During enrollment in the original study, patients disclosed information regarding BMI, physical activity, smoking status, education, and family history of early heart attack.

Patients were classified by BMI: normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (>30 kg/m2), and by physical activity level (low or high).

During follow-up, the study authors found that 16% of patients experienced a cardiovascular event, such as heart attack or stroke. Regardless of BMI, the researchers found that physical activity was linked to a reduced risk of cardiovascular disease, according to the study. The researchers did not discover a direct association between BMI and cardiovascular disease.

"In the overall population, we found that physical activity was protective for cardiovascular risk," Dr Dhana said. "Overweight and obese participants were not at increased cardiovascular risk compared to those of normal weight. We do not refute the risk associated with obesity in the general population even though we did not find it in this older group. BMI may not be the best way to measure adiposity risk in the elderly."

Compared with those with average weight and high activity levels, patients who were overweight/obese with high levels of physical activity were not observed to have an increased risk of cardiovascular disease, according to the study. However, individuals who were overweight/obese with low activity levels were up to 1.35 times more likely to develop cardiovascular disease.

"Our results show that physical activity plays a crucial role in the health of middle age to elderly people," Dr Dhana said. "Those who are overweight and obese without adequate physical activity are at higher risk of developing cardiovascular disease."

Excess weight and adipose tissue can speed the atherosclerotic process, thus increasing the risk of cardiovascular disease. However, exercise is able to reduce the stabilization of plaques on blood vessels, and lessen the heart’s demand for oxygen, according to the study.

"People who engage in high levels of physical activity are protected from the harmful effects of adipose tissue on cardiovascular disease," Dr Dhana said. "This may be why we found that the beneficial impact of physical activity on cardiovascular disease outweighs the negative impact of BMI."

Patients included in the study were generally considered active, with all participants engaging in at least 2 hours of activity per day. Activities included biking, walking, housework, and any other instances that involved movement.

The study authors note that the more activities an elderly individual participated in, the more they reduced their risk of cardiovascular disease. These findings may be important in recommending new strategies in preventing cardiovascular events in this population.

"Any physical activity is positive for cardiovascular health and in elderly people of all weights walking, biking and housework are good ways to keep moving," Dr Dhana said. "European guidelines recommend 150 minutes a week of moderate intensity physical activity to decrease the risk of cardiovascular disease.”