The Impact of Retirement on Cardiovascular Disease and its Risk Factors

A Systematic Review of Longitudinal Studies

Baowen Xue, PhD; Jenny Head, MSc; Anne McMunn, PhD


Gerontologist. 2020;60(5):e367-e377. 

In This Article

Abstract and Introduction


Background and Objectives: People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet).

Research Design and Methods: Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals.

Results: Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers.

Discussion and Implications: Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.


Global population aging has led to shrinking ratios of workers to pensioners and people are now spending longer in retirement than ever before. Government policy in many industrialized countries is to raise state pension ages (SPA). The potential health effects of retirement are largely neglected in the political debate. In contrast, there is a growing academic literature on the health effects of retirement.

Although empirical studies have demonstrated the effect of retirement on health outcomes, evidence on the impact of retirement on cardiovascular disease (CVD), however, is ambiguous and has not yet been systematically summarized. For instance, Behncke (2012) found that retirees had a higher risk of being diagnosed with CVD than working people. However, Westerlund and colleagues (2010) showed that retirement had no effect on CVD while Moon, Glymour, Subramanian, Avendaño, and Kawachi (2012) suggested that CVD incidence increased in the first year after retirement, but this effect was weaker from the second-year postretirement. CVD is the greatest cause of death globally and has imposed a large burden in many countries (WHO, 2017) and the development of CVD might be complicated. Retirement may influence the development of CVD through behavioral pathways, such as changes in smoking, alcohol consumption, physical activity, and diet. These health behaviors themselves are risk factors for CVD (Mendis, Puska, & Norrving, 2011), and can affect other CVD metabolic risk factors, such as diabetes and hypertension (Roerecke et al., 2017; Schwingshackl, Missbach, König, & Hoffmann, 2015). Furthermore, retirees' CVD risk may also be influenced by retirement-related changes in mental and physical health (Elderon & Whooley, 2013; Williams et al., 2012).

The aim of this study is to provide a systematic literature review, which summarizes the available evidence on the effects of retirement on CVD and its risk factors among the older population. We did not limit the age range of the study population due to different retirement ages among different countries. This review contributes to literature by, (a) filling an important gap in the literature by systematically summarizing the currently ambiguous research on the effect of retirement on CVD and (b) providing policymakers insights into the possible impact of retirement on CVD that may aggravate or alleviate pressures on the healthcare system.