- Several lifestyle changes can help lower the risk for heart disease, including being physically active.
- A new study found that adults who developed heart disease later in life experienced a decline in their physical activity about 12 years before their cardiovascular event.
- Scientists also discovered that Black male participants had a more continuous decline in physical activity from young adulthood to middle age, and Black female participants consistently reported the lowest physical activity throughout adulthood, highlighting disparity.
“Cardiovascular disease is largely preventable through lifestyle modifications, and physical activity is one of the most powerful tools we have,” Yariv Gerber, PhD, professor in the Department of Epidemiology and Preventive Medicine at the School of Public Health, Gray Faculty of Medical and Health Sciences at Tel Aviv University, Israel, told Medical News Today.
“Lifelong physical activity is essential for maintaining function, preventing disability, and reducing the risk of cardiovascular and metabolic diseases. However, staying active over time can be difficult, especially during life transitions or after health events — periods when people are most vulnerable to decline,” Gerber said.
He is one of the authors of a new study published in the journal
Upon the study’s conclusion, researchers found that most study participants experienced a decline in their moderate-to-vigorous physical activity (MVPA) levels from young adulthood to middle age, which then evened out in later years.
“While not every individual declined, on average, all demographic groups showed reductions in physical activity from young adulthood through midlife,” Gerber said.
“This highlights how difficult it is to maintain healthy behaviors over time, even among generally healthy adults. Since physical activity is so closely tied to cardiovascular and overall health, it’s essential to recognize when these declines occur — and to intervene early, ideally before habits become ingrained or health starts to deteriorate,” he noted.
When looking at the correlation between physical activity and heart disease, Gerber and his team discovered that many participants’ MVPA levels began declining about 12 years before a heart disease diagnosis, such as coronary heart disease, stroke, or heart failure.
And researchers noticed in many cases an accelerated physical activity decline within two years of their cardiovascular event.
Gerber explained that it takes years for cardiovascular disease to develop.
“The fact that we observed declines in physical activity more than a decade before diagnosis suggests that there’s a long window of opportunity for prevention. Physical activity directly influences key risk factors like blood pressure, lipid levels, glucose, and body weight. Sustaining activity across adulthood could help delay or prevent cardiovascular disease onset — especially if we can identify and support individuals at risk of physical activity decline during these early stages.”
— Yariv Gerber, PhD
And when looking at participants by ethnicity, researchers found that Black male participants had a more continuous decline in physical activity from young adulthood to middle age, and Black female participants consistently reported the lowest physical activity throughout adulthood.
“These differences are deeply concerning,” Gerber said. “The study underscores the need for early and sustained preventive interventions — especially among populations historically at higher risk. Black women, in particular, showed consistently low MVPA levels and the highest risk of low activity post-cardiovascular disease.”
“Addressing this requires culturally tailored strategies, including easy access to safe recreational spaces, affordable facilities, transportation support, and system-level efforts to make physical activity more accessible to all,” he continued. “Integrating physical activity promotion into routine care is also critical; even brief counseling has been shown to increase activity levels, despite the time constraints often cited by providers.”
MNT spoke with Jonathan Fialkow, MD, chief of cardiology at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida, about this study.
Fialkow commented this was an interesting review of a population correlating maintaining moderate to intense physical activity to gender, race, and age, with some components showing declines in people who develop cardiac disease.
“We are aware of the benefits of moderate-intense physical activity for cardiac and metabolic health,” he continued. “To better understand populations at risk for achieving these benefits, we can better target them for education and support. Limitations in the study exist, but ultimately, we may be able to find other determinants in social, financial, behavioral, and lifestyle elements that may contribute to obstacles to more intense and regular physical activity, so we can address them.”
MNT also talked to Jennifer Wong, MD, a board certified cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, about this research, who said it was useful to see the timing of physical activity decline and cardiovascular events.
“This underscores the importance of physical activity for preventing cardiovascular disease,” Wong explained. “Prevention is key for our cardiovascular health. I find it helpful to look at the impact of modifiable risk factors and prioritize the more effective strategies.”
“I would like a better understanding of why the decline in physical activity is associated with increased cardiovascular events,” she continued. “Did the decline occur because of progression of cardiovascular disease? Did symptoms of coronary ischemia or heart failure lead to the decline in activity? Or did the decrease in physical activity lead to more cardiovascular disease?”
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