Among postmenopausal women with a history of cancer, taking more daily steps and engaging in moderate-to-vigorous physical activity were both associated with a significantly reduced risk of death from cardiovascular disease, according to preliminary research presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2025. The meeting will be held in New Orleans, March 6-9, 2025, and features the latest science on population-based health and wellness and implications for lifestyle.

Physical activity is a key component of the American Heart Association’s Life’s Essential 8, a list of health behaviors and factors that support optimal cardiovascular health. The Association currently recommends that adults engage in at least 150 minutes per week of moderate-intensity physical activity (such as walking or gardening) or 75 minutes per week of vigorous-intensity physical activity (such as running or swimming), or a combination of both.

Cancer survivors are at an increased risk of death from cardiovascular disease, according to a 2019 scientific statement from the Association. The statement also noted that exercise training is an essential part of cardiac rehabilitation and recovery after 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 mortality. Our study helps us to better understand potential physical activity behaviors of postmenopausal women in relation to cancer survival.”

Eric Hyde, Ph.D., M.P.H., lead study author, research analyst at the University of California, San Diego

Researchers examined physical activity data from the Women’s Health Accelerometry Collaboration, a study combining two observational studies exploring the relationship among physical activity and sedentary behavior with cancer incidence and death. They assessed the potential associations of physical activity and sedentary behavior with death from cardiovascular disease or all-cause mortality (death from any cause).

The study followed for about eight years nearly 2,500 post-menopausal women between the ages of 63 and 99 years. The analysis included participants diagnosed with breast or other cancers at least one year before enrolling in the studies. Participants wore an accelerometer on the hip for at least 10 hours per day for up to one 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 including 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 study found:

• 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 participants who logged 5,000–6,000 steps per day, and their risk of all-cause mortality was reduced by 40%. 
• Each additional 2,500 steps per day was also incrementally associated with a 34% reduction in risk of death from cardiovascular disease.
• The greatest benefit from moderate-to-vigorous physical activity was seen among participants with at least one hour per day, which reduced all-cause mortality risk by 40% and cardiovascular disease mortality risk by 60%. However, significant reductions in risk were also evident at amounts far below one hour per day, researchers noted.
• 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 death from cardiovascular disease. 

“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,” Hyde said. “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.”

Keith Diaz, Ph.D., the Florence Irving Associate Professor of Behavioral Medicine at Columbia University Medical Center in New York, a certified exercise physiologist and a member of the Association’s Physical Activity Science Committee, noted that the study’s findings add to the understanding of how to manage health and promote longevity after a cancer diagnosis.

“While structured exercise remains the most efficient and effective way to improve your 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 people navigating life after cancer,” said Diaz, who was not involved in the study.

“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.”

Study details, background and design:

• The analysis included 2,479 women with a history of cancer, with an average age of 74 years. 52% of the study participants had a history of breast cancer; 8.5%, endometrial cancer; 7.1%, malignant melanoma; 6.6%, colon cancer; 3.0%, lung cancer; 2.1%, bladder cancer; 2.1%, rectal cancer; 2.1%, ovarian cancer; 1.7%, kidney cancer; 0.9%, head and neck cancer; 0.7%, myeloma; and 13% had a cancer that was categorized as “other.”
• Data was from the Women’s Health Accelerometry Collaboration, a consortium of two studies (the Women’s Health Initiative and the Women’s Health Study) conducted between 2011 and 2015. The follow-up period to evaluate health outcomes was conducted through the end of 2022.
• Daily accelerometer physical activity measures included light physical activity, moderate-to-vigorous physical activity, total physical activity and steps.
• Examples of light physical activity included housework or slow walking, and moderate-to-vigorous physical activity included brisk walking, running, bike riding, playing tennis and heavy yardwork.

The study had several limitations, including lack of data regarding cancer stage at diagnosis and treatment, and physical activity was measured only once after 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,” Hyde said.