Effects of Physical Activity and Sedentary Time on the Risk of Heart Failure

Abstract

Background— Although the benefits of physical activity for risk of coronary heart disease are well established, less is known about its effects on heart failure (HF). The risk of prolonged sedentary behavior on HF is unknown. Methods and Results— The study cohort included 82 695 men aged ≥45 years from the California Men’s Health Study without prevalent HF who were followed up for 10 years. Physical activity, sedentary time, and behavioral covariates were obtained from questionnaires, and clinical covariates were determined from electronic medical records. Incident HF was identified through International Classification of Diseases, Ninth Revision codes recorded in electronic records. During a mean follow-up of 7.8 years (646 989 person-years), 3473 men were diagnosed with HF. Controlling for sedentary time, sociodemographics, hypertension, diabetes mellitus, unfavorable lipid levels, body mass index, smoking, and diet, the hazard ratio (95% confidence interval [CI]) of HF in the lowest physical activity category compared with those in the highest category was 1.52 (95% CI, 1.39–1.68). Those in the medium physical activity category were also at increased risk (hazard ratio, 1.17 [95% CI, 1.06–1.29]). Controlling for the same covariates and physical activity, the hazard ratio (95% CI) of HF in the highest sedentary category compared with the lowest was 1.34 (95% CI, 1.21–1.48). Medium sedentary time also conveyed risk (hazard ratio, 1.13 [95% CI, 1.04–1.24]). Results showed similar trends across white and Hispanic subgroups, body mass index categories, baseline hypertension status, and prevalent coronary heart disease. Conclusions— Both physical activity and sedentary time may be appropriate intervention targets for preventing HF.

Dose–Response Relationship Between Physical Activity and Risk of Heart Failure

“…[15][16][17] In contrast, the role of PA in reducing risk of HF has not been emphasized in existing guidelines and public health recommendations. 15 Although observational cohort studies have reported an inverse association between higher levels of PA and HF risk, [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] a comprehensive assessment of the quantitative dose-response association between PA and HF risk has not been previously reported. Understanding this relationship is important because recent studies suggest that there may be important differences in the mechanisms through which PA modifies HF risk and CHD risk, 20 and the dose of PA needed to significantly lower HF risk may differ from that currently recommended to reduce CHD risk.…”

Association of Physical Activity or Fitness With Incident Heart Failure

“…20,21 The US-based studies included multiethnic populations; but overall the proportion of white individuals in these studies was >50%. Two studies enrolled men only 19,23 and one only women, 21 whereas the rest enrolled both the sexes. The age range of participants was 25 to 97 years.…”

Living near the port area is associated with physical inactivity and sedentary behavior

“…8 It is well known that physical inactivity is related to health impairments, but sedentary behavior has recently emerged as a new independent risk factor for chronic diseases as well as for mortality, regardless of moderate-to-vigorous physical activity. [9][10][11][12][13][14] Examples of sedentary behavior include watching television, sitting, playing video games and using computers. 15 Current studies have been investigating associations of physical activity and sedentary behaviors separately or combined.…”