Pankaj Arora, M.D. (left) and Amrita Nayak, M.D. (right) Research at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine highlights that higher levels of moderate to vigorous physical activity are associated with lower rates of serious cardiovascular events in people who carry genetic variants for cardiomyopathy.
Cardiomyopathy is a group of diseases that weaken the heart muscle and are a leading cause of heart failure and sudden cardiac death. Families who have a history of cardiomyopathy and those who inherit certain gene changes related to cardiomyopathy are at increased risk of developing heart problems.
The study, published in the American Journal of Preventive Cardiology, focused on individuals who carry these variants but have not yet developed any signs of the disease — a critical window in which lifestyle interventions like physical activity can modify cardiovascular risk.
Using data from more than 15,000 participants in the All of Us Research Program, the research team combined genetic testing results with activity data from wearable fitness devices to examine whether exercise minimized cardiovascular events. All participants with existing heart disease were excluded.
“Our findings suggest that, even among people who carry genetic variants for cardiomyopathy but have no signs of disease, staying physically active may be associated with lower rates of future cardiovascular events,” said Pankaj Arora, M.D., senior author and director of the UAB Cardiogenomics Clinic. “Genetic risk may not be deterministic, and exercise is a modifiable factor that people can act on to help protect their heart.”
Among the 831 gene carriers identified, those getting less than 150 minutes per week of moderate to vigorous activity had the highest cardiovascular event rates. Carriers who met the World Health Organization’s recommended activity levelshad lower event rates, a pattern consistent across both carriers and non-carriers.
“What makes this study stand out is that we used real-world data from wearable devices rather than self-reported exercise habits, which can be unreliable,” said Amrita Nayak, M.D., the first author of the study. “It’s exciting to see that, even among people carrying these high-risk gene variants, staying active appears to make a difference.”
Nayak further explains that, according to pre-clinical studies, exercising before disease development can reduce inflammation, prevent scar tissue buildup and reduce harmful signals in the heart.
According to Garima Arora, M.D., co-author of the study and co-director of the UAB Cardiogenomics Clinic, this study offers a hopeful message for individuals carrying a cardiomyopathy variant.
“People can learn whether they carry the cardiomyopathy gene through genetic testing and incorporate physical activity into their lifestyles to stay heart-healthy and protect themselves against heart disease,” Garima Arora said.
The researchers caution that these findings may not apply to carriers of certain high-risk variants, particularly in the plakophilin-2 and lamin A/C genes, where high-intensity exercise may worsen disease progression. For these individuals, a cardiologist or genetic heart disease specialist should guide exercise recommendations.
“This study is a powerful example of how wearable technology and large-scale genomic data can come together to inform cardiovascular prevention strategies,” Pankaj Arora said. “It opens the door to future trials that could define the optimal exercise prescription for people living with inherited heart disease risk, especially those who haven’t yet developed the disease.”
The authors emphasized the need for continued expansion of genetic testing and wearable health technology to ensure that individuals across all communities can benefit from personalized approaches to reduce cardiovascular risk.