A new study gives people in their 50s and 60s another reason to get off the couch and be physically active—especially if they have conditions or habits that endanger their hearts, such as diabetes, high blood pressure or smoking.

The study, based on data from 9,611 older adults, shows that those who were regularly active in their 50s and early 60s were about 35 percent less likely to die in the next eight years than those who were sedentary. For those who had a high heart disease risk because of several underlying conditions, the reduction was 45 percent.

The adults in the study didn’t have to run marathons to get the death-reducing benefit: The reduction was seen even among those who walked, gardened or went dancing a few times a week, as well as those who pursued more vigorous activities. Even those who were obese had a lower risk of dying if they were regularly active.

The results, published in the November issue of the journal Medicine and Science in Sports and Exercise, are from a study by researchers at the Medical School and the VA Ann Arbor Health Care System. It used data from the Health and Retirement study conducted by the Institute for Social Research (ISR) beginning in 1992.

The findings suggest that efforts to get middle-aged people to exercise should focus on those with risk factors for cardiovascular disease or a prior heart attack or stroke.

It’s the first known prospective, nationally representative study to show that cardiovascular risk doesn’t lessen exercise’s impact on mortality risk. It confirmed that those who have a high heart risk are much more likely to be sedentary, possibly out of fear that exercising could overtax them.

“Other studies in smaller or less representative groups have shown the long-term benefits of exercise, even light exercise, but this study allowed us to look across different population groups and different levels of cardiovascular risk, and see who got the most ‘punch’ out of exercise,” says lead author Dr. Caroline Richardson, assistant professor of family medicine who performed the study when she was a Robert Wood Johnson (RWJ) Clinical Scholar at U-M.

“We found that across all ranges of cardiovascular risk, everybody got a benefit from regular activity, but the biggest absolute benefit, the biggest reduction in deaths, was among high-risk people,” she says.

The large size of that effect surprised Richardson and her colleagues, including her RWJ mentor Dr. Rodney Hayward, senior author on the paper and professor of internal medicine at the Medical School, as well as a member of the Survey Research Center at ISR and director of the VA Center for Practice Management and Outcomes Research.

The result convinced the authors that a concerted effort is needed to encourage exercise among currently sedentary people, especially those with cardiovascular risk factors.

“If we exclude high-risk folks from studies or discourage them from being active, then we have lost the chance to make a big impact,” Richardson says. “We need to prevent people from becoming part of that high-risk group, by encouraging exercise as a way to lower their weight, blood sugar and blood pressure. But at the same time we need to address those at high risk now.”

In addition to Richardson and Hayward, the authors were Paula Lantz of ISR and the School of Public Health (SPH) and Andrea Kriska of the University of Pittsburgh School of Public Health. Hayward also holds an appointment at SPH.

The Health and Retirement Study was funded by the National Institute on Aging. The analysis published in the current paper was partially supported by the RWJ Clinical Scholars Fellowship Program at U-M and by the Veterans Administration Health Services Research and Development Unit at the VA Ann Arbor Health Care system.