Risk for all-cause and cardiovascular mortality is substantially reduced in women compared with men when they participate in the same amount of physical activity (PA) during leisure time, a new analysis of national survey data shows. Hongwei Ji, MD, of Tsinghua University, Beijing, Martha Gulati, MD, MS, of Cedars-Sinai Medical Center, Los Angeles, and colleagues reported these results in a manuscript published Monday online and in the Feb. 27 issue of the Journal of the American College of Cardiology. Many people know greater amounts of PA are associated with a better outlook for cardiovascular health, including survival. However, few people are aware that there is a gender gap when it comes to levels of PA. Women are less likely to meet the recommended guidelines for physical activity per week, and this gap begins early in life and continues throughout adulthood. Studies have shown gender differences when it comes to PA health outcomes. The investigators in this study aimed to understand the benefits for men and women based on the degree of PA using frequency, duration, intensity and type of exercise as measures. A total of 412,413 adults in the U.S. (mean age=44 years, 55% female) had their surveys included in this study. Sex-specific multivariable-adjusted associations of the four physical activity measures were examined alongside all-cause and cardiovascular mortality between 1997 and 2019. Data were collected using the Centers for Disease Control and Prevention’s National Center for Health Statistics. Across 4,911,178 person-years of follow-up, 39,935 patients died, and 11,670 of those deaths had cardiovascular causes. A 24% lower risk (hazard ratio [HR]=0.76; 95% confidence interval [CI]=0.82-0.89) of all-cause mortality in women was observed in leisure-time PA compared with inactivity, while for men, all-cause mortality risk was reduced by 15% for leisure-time PA compared to inactivity (HR=0.85; 95% CI=0.82-0.89). The maximal reduced mortality risk in men was 19% (HR 0.81) from 300 minutes per week of moderate-to-vigorous physical activity, while women had similar benefits at 140 minutes per week and had a maximum reduced mortality risk of 24% (HR 0.76), also around 300 minutes per week. Cardiovascular death (Wald F=20.1, sex interaction p<0.001) showed similarities in sex-specific findings, and so did all measures of aerobic activity and muscle-strengthening activity (Wald F=6.7, sex interaction p=0.009). Overall, women had greater risk reduction in all-cause and cardiovascular mortality from equivalent doses of leisure time PA compared with men. Significant sex differences were also observed in association of self-reported PA in this cohort. “We hope this study will help everyone, especially women, understand they are poised to gain tremendous benefits from exercise,” said Susan Cheng, MD, a cardiologist and the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science in the Smidt Heart Institute at Cedars-Sinai, in a news release. “It is an incredibly powerful way to live healthier and longer. Women on average tend to exercise less than men and hopefully these findings inspire more women to add extra movement to their lives.” In an accompanying editorial, Wael A. Jaber, MD, and Erika Hutt, MD, of the Cleveland Clinic, discussed the current approaches to recommendations for PA among genders and the effect of PA on heart disease and cardiovascular mortality risk. They highlighted the importance of this study for women, in particular. “Despite the progress made within the last 2 decades of a research focus on sex differences related to cardiovascular disease (CVD), this disease remains the leading cause of death in women in the United States,” the editorialists wrote. They added that the present study is likely valid thanks to the former research done about women, PA and cardiovascular disease. The editorialists wrote about the significance of the implications of this study and the importance of applying these findings to policies and PA recommendations. “Overall, the study by Ji et al is well designed and adds important information to the body of literature that can potentially close the gender gap and optimize sex-specific physical activity recommendations by policy makers and societal guidelines,” the editorialists concluded. Sources: Ji H, Gulati M, Huang TY et al. Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality. J Am Coll Cardiol. 2024;83:783-793. Jaber WA, Hutt E. Sex-Specific Mortality Benefits Related to Exercise J Am Coll Cardiol. 2024;83:794-795. Image Credit: Flamingo Images – stock.adobe.com