EXERCISE INTENSITY AND SUBCLINICAL CARDIOVASCULAR-DISEASE IN THE ELDERLY - THE CARDIOVASCULAR HEALTH STUDY

The authors assessed the cross-sectional association between intensity of exercise in later life and coronary heart disease risk factors and subclinical disease among 2,274 men and women, 65 years of age and ol der, who were participants in the Cardiovascular Health Study (CHS) du ring 1989-1990. Subjects were free of prior clinical cardiovascular di sease or impairment of physical function. Exercise intensity was chara cterized as low, moderate, or high, based on highest intensity exercis e reported over the 2 weeks prior to the CHS baseline examination. Aft er adjustment for age, education, and postmenopausal hormone therapy ( among women), there was an inverse dose-response relationship of exerc ise intensity with selected risk factors. By low, moderate, and high e xercise intensity, respectively: fasting insulin-men, 15.6 mu U/ml, 14 .1 mu U/ml, and 12.6 mu U/ml, p for trend <0.001; women, 14.8 mu U/ml, 13.8 mu U/ml, and 12.0 mu U/ml, p for trend=0.01; serum fibrinogen-me n, 316.2 mg/dl, 315.4 mg/dl, and 300.0 mg/dl, p for trend=0.01; women, 327.3 mg/dl, 317.0 mg/dl, and 310.7 mg/dl, p for trend=0.01; lower ex tremity arterial disease by percent with ankle-arm index <0.9-men, 18. 3, 5.5, and 3.7,p for trend=0.01; women, 10.0, 5.7, and 2.8, p for tre nd=0.02; evidence of myocardial injury by cardiac infarction/injury sc ore (CIIS)-men, 8.0, 6.0, 3.9, p for trend <0.001; women, 4.6, 3.9, an d 3.6, p for trend=0.03. Adjustment for smoking, alcohol consumption, and total kilocalories expended in exercise altered the findings only slightly. The authors conclude that intensity of exercise in later lif e is associated with favorable coronary disease risk factor levels and a reduced prevalence of several markers of subclinical disease.