Women gain greater heart benefits from exercise than men, activity tracker analysis finds

Female individuals may experience a three-fold reduction in mortality risk from coronary heart disease when following recommended exercise guidelines, compared to male individuals. These findings, published in Nature Cardiovascular Research, suggest that sex-specific recommendations could improve coronary heart disease prevention and management.

Coronary heart disease remains the leading cause of illness and death worldwide. Current guidelines from the World Health Organization, American Heart Association and European Society of Cardiology recommend at least 150 minutes of moderate-to-vigorous physical activity per week for all adults. However, these guidelines adopt a uniform approach despite evidence of a “gender gap” in exercise capacity, but how coronary heart disease may relate to this gap is unclear.

Jiajin Chen and colleagues analyzed UK Biobank data collected from wrist-worn activity trackers from more than 85,000 participants to examine sex differences in the association between physical activity and coronary heart disease outcomes. Among 80,243 participants (45,986 females and 34,257 males) without coronary heart disease, female participants that met the guideline target of 150 minutes of exercise per week had a 22% lower risk of coronary heart disease, compared with 17% in male participants.

Further analysis showed that women achieved a 30% reduction in coronary heart disease risk with 250 minutes of activity per week, whereas men would require 530 minutes to achieve a comparable reduction. In 5,169 participants (1,553 females and 3,616 males) with coronary heart disease, adherence to guidelines was linked to a three-fold greater reduction in all-cause mortality risk in women compared with men.

The findings highlight that current guidelines overlook sex differences, and that sex-specific strategies could improve coronary heart disease prevention. Further research in more diverse populations is needed to confirm these findings and inform tailored recommendations.