Taking more daily steps and engaging in moderate-to-vigorous physical activity may both be associated with a reduced risk of cardiovascular disease–related mortality among postmenopausal women with a history of cancer, according to preliminary findings presented by Hyde et al at the American Heart Association’s (AHA) Epidemiology and Prevention, Lifestyle, and Cardiometabolic Health Scientific Sessions 2025 (Oral Presentation 058).
Background
Physical activity is a key component of the AHA’s Life’s Essential 8—a list of health behaviors and factors that support optimal cardiovascular health. The association currently recommends that adults achieve at least 150 minutes per week of moderate-intensity physical activity such as walking or gardening, 75 minutes per week of vigorous-intensity physical activity like running or swimming, or a combination of both.
Cancer survivors often have an increased risk of mortality from cardiovascular disease, according to a 2019 Scientific Statement from the AHA published in Circulation. The statement also noted that exercise training may be an essential part of cardiac rehabilitation and recovery following cancer treatment and that exercise therapy can help to reduce cardiovascular toxicity during cancer treatment.
“Encouraging cancer survivors to be more active, sit less, and take more steps every day could be a feasible approach for prolonging survivorship and reducing the risk of cardiovascular disease–[related] mortality,” emphasized lead study author Eric Hyde, PhD, MPH, a research analyst at the University of California, San Diego. “Our study helps us to better understand potential physical activity behaviors of postmenopausal women in relation to cancer survival,” he added.
Study Methods and Results
In the study, investigators used data from the Women’s Health Accelerometry Collaboration—which combined the observational Women’s Health Initiative and Women’s Health Study exploring the relationship of exercise and sedentary behavior with cancer incidence and mortality—to assess the potential association between physical activity and both cardiovascular disease–related and all-cause mortality among 2,479 postmenopausal women (aged 63–99) with a history of cancer. The investigators noted that the study participants had a history of breast cancer (52%), endometrial cancer (8.5%), melanoma (7.1%), colon cancer (6.6%), lung cancer (3.0%), urothelial carcinoma (2.1%), rectal cancer (2.1%), ovarian cancer (2.1%), renal cancer (1.7%), head and neck cancer (0.9%), myeloma (0.7%), and a cancer categorized as other (13%). They followed up with the patients for about 8 years.
The analysis included patients diagnosed with breast cancer or other cancer types at least 1 year prior to enrollment. The patients were asked to wear accelerometers on the hips for at least 10 hours per day for up to 1 week. The device recorded daily physical activity, including light physical activity, moderate-to-vigorous physical activity, total physical activity, and step counts. It also recorded sedentary behavior such as total sitting time during awake hours.
After adjusting for age, race/ethnicity, various lifestyle and risk factors for cardiovascular disease, cancer type, and years since cancer diagnosis, the investigators found that more daily steps and more moderate-to-vigorous physical activity were associated with a progressively lower risk of all-cause mortality. The greatest benefit was seen among the patients who achieved 5,000 to 6,000 steps per day, whose risk of all-cause mortality was reduced by 40%.
Each additional 2,500 steps per day was incrementally associated with a 34% reduction in the risk of mortality from cardiovascular disease. The greatest benefit from moderate-to-vigorous physical activity was seen among those with at least 1 hour per day of moderate-to-vigorous physical activity, which reduced the risks of all-cause mortality by 40% and cardiovascular disease–related mortality by 60%. However, significant reductions in risk were also evident at amounts far below 1 hour per day. Every 102 minutes of sitting time per day was associated with a 12% increased risk of all-cause mortality and a 30% higher risk of cardiovascular disease–related mortality.
“Risk reductions were even evident when participants walked fewer than 5,000 steps per day, half of the often touted 10,000 steps per day threshold,” Dr. Hyde stressed. “Daily steps are an important measure because they are easily understood by the public, can be at any intensity level, and are recorded on wearable devices like smartwatches that are increasingly being worn by all,” he continued.
Conclusions
The investigators indicated that the findings may add to the current understanding of how to manage health and promote longevity following a cancer diagnosis.
“While structured exercise remains the most efficient and effective way to improve … health, these findings highlight that walking—at any intensity—matters. The road to an active lifestyle is more accessible than we often assume, and the benefits are available to everyone, including [patients] navigating life after cancer,” underscored Keith Diaz, PhD, the Florence Irving Associate Professor of Behavioral Medicine at Columbia University Medical Center as well as a certified physiologist and member of the Physical Activity Science Committee at the AHA, who was not involved in the research. “Another key takeaway from this study is the impact of sedentary time. Many adults now spend the majority of their day sitting, not engaged in physical activity—and for cancer survivors, this issue is likely even more pronounced due to the physical toll of cancer treatment and recovery. These findings add to the growing body of evidence that prolonged sitting is a significant health risk, one that we must actively combat, particularly after a cancer diagnosis,” he reiterated.
The study had several limitations, including a lack of data regarding cancer stage at diagnosis and treatment, and physical activity was measured only once following a cancer diagnosis.
“In future studies, physical activity should be measured at several critical time points such as before cancer diagnosis, during treatment, and after treatment to clarify how these changes in behavior may relate to survival,” Dr. Hyde concluded.
Disclosure: For full disclosures of the study authors, visit aha.abstractarchives.com.
