A new study finds that the number of women in the United States with cardiovascular disease who are not doing enough physical activity is on the rise.

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Women between 40 and 64 years of age are getting less and less exercise, new research shows.

Cardiovascular disease is the leading cause of death among women in the U.S.

The American Heart Association (AHA) estimate that every year the condition kills 400,000 women — approximately the same number of females who die from cancer, chronic lower respiratory disease, and diabetes put together.

When variables such as race are considered, the statistics become even more dramatic. The prevalence of heart disease among African American women is much greater than among white women.

Despite this, most cases of cardiovascular disease can be prevented with healthy lifestyle choices, such as exercising and following a balanced, healthful diet.

A new study that researchers from the Johns Hopkins University School of Medicine in Baltimore, MD, have conducted found that more than half of women with cardiovascular disease continue not to exercise enough, and the number has increased over the past decade.

The results of the study appear in the journal JAMA Network Open.

The study suggests that more needs to be done to improve physical activity among women with cardiovascular disease who would benefit from increasing their exercise levels — to ensure they experience optimal heart health.

This intervention would also decrease their healthcare costs associated with cardiovascular disorders.

“Physical activity is a known, cost-effective prevention strategy for women with and without cardiovascular disease, and our study shows worsening health and financial trends over time among women with cardiovascular disease who don’t get enough physical activity,” says Victor Okunrintemi, internal medicine resident at East Carolina University, and author on the study.

The AHA and the Centers for Disease Control and Prevention (CDC) have similar physical activity guidelines. They recommend that adults do at least 150 minutes of moderate activity a week or 30 to 75 minutes of vigorous activity per week.

The new study found that more than half of women in the U.S. with cardiovascular conditions continue to not meet these guidelines.

The researchers used data from a 2006–2015 questionnaire by the U.S. Agency for Health Care Research and Quality’s Medical Expenditure Panel Survey, which included more than 18,000 women of different races (non-Hispanic white, Asian, African American, and Hispanic) with cardiovascular disease.

The research team looked at the answers collected in 2006–2007 and then compared them with those from 2014–2015.

They found that the number of women with cardiovascular disease not meeting the recommended physical activity guidelines increased from 2006 to 2015, rising from 58% to nearly 62%. They also found trends related to age, race, and socioeconomic factors.

Their findings showed that women between 40–64 years old were the age group that was increasing the fastest for not getting enough exercise.

African American, Hispanic, and women with low-income levels and low education were more likely to not exercise enough.

The study also revealed that women with cardiovascular disease who did not exercise saw an increase in their healthcare costs between 2006–2007 and 2014–2015.

Expenditure was around $12,700 in 2006–2007 and $14,800 in 2014–2015. In comparison, women with cardiovascular disease who did exercise enough spent about $8,800 in 2006–2007 and $10,500 in 2014–2015.

The researchers explained that the study was not focused on cause/effect, but it aimed at identifying 10-year trends in the levels of physical activity among U.S. women, considering variables such as age, race/ethnicity, and socioeconomic factors.

“Many high-risk women need encouragement to get more physically active in hopes of living healthier lives while reducing their health care costs,” says Erin Michos, lead author of the study and associate professor of medicine at the Johns Hopkins University School of Medicine.

The researchers concluded that healthcare providers need to encourage vulnerable groups, such as older women, women with lower socioeconomic status, and those from minority groups to follow physical activity guidelines.

Also, they say there is a need for additional support for doctors to enable them to support their heart patients to do more heart-heathly exercise, and to share tips to make their activity tasks easier and more enjoyable.