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The objective of this study was to determine the association between level and change in physical activity from young adulthood to middle age and incidence of premature CVD events before age 60.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data collected across four urban sites from nine visits over 30\u2009years of follow-up (1985\u20132016) from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort study of 5115 Black and White women and men aged 18\u201330\u2009years at baseline (1985\u20131986). Linear mixed models were used to develop individualized moderate-to-vigorous intensity self-reported physical activity trajectories per participant. Fatal and nonfatal coronary heart disease (CHD), heart failure, and stroke outcomes were analyzed separately and as a combined CVD event outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, physical activity declined in young adults as they progressed through middle age. Lower physical activity scores (per 100 exercise units) in 18\u2009year-olds were associated with higher odds of premature CHD (AOR 1.14, 95% CI 1.02\u20131.28), heart failure (AOR 1.21, 95% CI 1.05\u20131.38), stroke (AOR 1.20, 95% CI 1.04\u20131.39), and any CVD (AOR 1.15, 95% CI 1.06\u20131.24) events. Each additional annual 1-unit reduction in the physical activity score was associated with a higher annual odds of incident heart failure (1.07, 95% CI 1.02\u20131.13), stroke (1.06, 95% CI 1.00\u20131.13), and CVD (1.04, 95% CI 1.01\u20131.07) events. Meeting the minimum (AOR 0.74, 95% CI 0.0.57\u20130.96) and twice the minimum (AOR 0.55, 95% CI 0.34\u20130.91) Department of Health and Human Services physical activity guidelines through follow up was protective of premature CVD events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given recent trends in declining physical activity with age and associated premature CVD events, the transition from young adult to midlife is an important time period to promote physical activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12966-022-01357-2","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T05:04:06Z","timestamp":1663650246000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Physical activity from young adulthood to middle age and premature cardiovascular disease events: a 30-year population-based cohort study"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6541-0604","authenticated-orcid":false,"given":"Jason M.","family":"Nagata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Vittinghoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelley Pettee","family":"Gabriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal S.","family":"Rana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea K.","family":"Garber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Moran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared P.","family":"Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Sidney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Bibbins-Domingo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"1357_CR1","first-page":"e139","volume":"141","author":"SS Virani","year":"2020","unstructured":"Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. 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