OBJECTIVE -To determine the impact of chronic exercise training initiated later in life upon development of metabolic markers of cardiovascular disease risk. RESEARCH DESIGN AND METHODS -Two inception cohorts of previously sedentary healthy adults aged 55-75 years at baseline (1989), one initiating regular supervised physical exercise training and the other a geographical similar sedentary control, were assessed for anthropometric, biochemical, and clinical markers of the metabolic syndrome and

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... comorbidity over 10 years. RESULTS -At baseline, active individuals aged 68 years compared with sedentary individuals aged 67 years had similar fitness levels (5.7 vs. 5.8 metabolic equivalents). At follow-up, complete data were obtained for 161 active and 136 sedentary subjects. Drop out occurred primarily because of failure to adhere to the exercise regimen and poor physical health for active and sedentary individuals, respectively. More metabolic abnormalities were seen in the sedentary group than in the active group for one or two (64 vs. 36%, P Ͻ 0.001) and three or more (35 vs. 22%, P Ͻ 0.003) abnormalities, respectively. In those assessed at follow-up, the sedentary group compared with the active group had lower fitness levels (5.0 [13.8% decrease] vs. 5.9 [3.5% increase] metabolic equivalents), had a greater likelihood of a positive exercise electrocardiogram or symptom (32 vs. 10%, P Ͻ 0.001), and had more comorbid conditions (Charlson Comorbidity Index score 0.9 vs. 0.4, P Ͻ 0.01). CONCLUSIONS -Higher fitness achieved over 10 years of regular exercise training in older adults was associated with reduced development of metabolic risk factors for cardiovascular disease, fewer exercise-induced cardiac abnormalities, and reduced comorbidity. Abbreviations: HOMA-IR, homeostasis model assessment of insulin resistance; MET, metabolic equivalent; RPP, rate-pressure product; sBP, systolic blood pressure. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.