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Evidence supports lifelong physical activity for preventing adverse cardiovascular (CV) events, but the CV benefit of initiating greater physical activity in older adults is unknown. In this multisite trial, 1635 sedentary elders (mean age, 79; 30% with histories of CV disease; 70% with ≥1 major CV risk factors; all with functional limitations but able to walk) were randomized to a structured physical-activity intervention or an education control group. Previously reported results from this trial showed significant improvements in functional mobility (NEJM JW Gen Med Jul 1 2014 and JAMA 2014; 311:2387).
The intervention involved two supervised exercise sessions weekly and home-based activity three to four times weekly; it included walking (goal, 150 minutes weekly) and strength training. Control patients attended weekly education sessions for 26 weeks and monthly sessions thereafter. During mean follow-up of 2.6 years, no significant differences were observed between groups in a broad composite outcome of adverse CV events or in a more limited outcome of myocardial infarction, stroke, or CV-related death.
Newman AB et al. Cardiovascular events in a physical activity intervention compared with a successful aging intervention: The LIFE Study randomized trial. JAMA Cardiol 2016 Jun 29; [e-pub]. (http://cardiology.jamanetwork.com/article.aspx?doi=10.1001/jamacardio.2016.1324)
Comment
In this study, greater physical activity in older adults did not prevent adverse CV events, possibly because the intervention came too late in life. Another possible explanation is that the control group's education intervention could have stimulated sufficient physical activity to minimize differences between the groups. In any case, starting exercise at an older age has other benefits, such as preserving and improving mobility, and this can be achieved without excess CV risk.