News briefs

Exercise intensity not linked to mortality risk in older adults, finds trial

Exercise intensity appears to make no difference to risk of mortality among older adults, suggests a randomised controlled trial from Norway published by The BMJ. An international research team set out to evaluate the effect of 5 years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (aged 70–77 years). The trial involved 1567 participants (790 women and 777 men) living in Trondheim, Norway, with an average age of 73 years. In total, 87.5% of participants reported overall good health and 80% reported a medium or high level of physical activity at the start of the trial. Four hundred participants were assigned to two weekly sessions of high intensity interval training (HIIT), 387 were assigned to moderate intensity continuous training (MICT), and 780 to follow the Norwegian guidelines for physical activity (control group), all for 5 years. After 5 years, the overall mortality rate was 4.6% (72 participants). The researchers found no difference in all‐cause mortality between the control group (4.7%, 37 participants) and combined HIIT and MICT group (4.5%, 35 participants). They also found no differences in cardiovascular disease or cancer between the control group and the combined HIIT and MICT group. The total proportion of participants with cardiovascular disease after 5 years was 15.6%, with 16% (125 participants) in the control group, 15% (58 participants) in the MICT group, and 15.3% (61 participants) in the HIIT group.

https://www.bmj.com/content/371/bmj.m3464

Pregnancy complications linked to heightened risk of heart disease, stroke in later life

Pregnancy complications such as miscarriage, pre‐eclampsia, gestational diabetes and pre‐term birth are linked to a heightened risk of heart disease in later life, suggests an umbrella analysis of data published by The BMJ. Previous research has suggested that risk factors specific to women may be linked to cardiovascular disease and stroke, but clarity is lacking on the quality of the evidence and how the findings can be translated into public health and clinical practice. A team of UK researchers searched relevant research databases for published systematic reviews and meta‐analyses that investigated links between reproductive factors in women of reproductive age and their subsequent risk of cardiovascular disease. A total of 32 reviews were included, evaluating multiple risk factors over an average follow‐up period of 7–10 years. The researchers found that several factors, including early menarche, use of combined oral contraceptives, polycystic ovary syndrome, miscarriage, stillbirth, pre‐eclampsia, diabetes during pregnancy, pre‐term birth, low birth weight and early menopause were associated with an up to twofold risk of cardiovascular outcomes. Pre‐eclampsia was associated with a fourfold risk of heart failure. Possible explanations for these associations include family medical history, genetics, weight, high blood pressure and cholesterol levels, and chemical imbalances from use of hormonal contraceptives. However, no association was found between cardiovascular disease outcomes and current use of progesterone‐only contraceptives, use of non‐oral hormonal contraceptive agents, or fertility treatment. Breastfeeding was associated with a lower risk of cardiovascular disease.

https://www.bmj.com/content/371/bmj.m3502