Prevention of heart failure in older adults may require higher levels of physical activity than needed for other cardiovascular events

Abstract Background Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. Methods We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥ 65 years, free of b...

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Bibliographic Details
Published in:International journal of cardiology 2013-10, Vol.168 (3), p.1905-1909
Main Authors: Patel, Kanan, Sui, Xuemei, Zhang, Yan, Fonarow, Gregg C, Aban, Inmaculada B, Brown, Cynthia J, Bittner, Vera, Kitzman, Dalane W, Allman, Richard M, Banach, Maciej, Aronow, Wilbert S, Anker, Stefan D, Blair, Steven N, Ahmed, Ali
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Confidence Intervals
Exercise - physiology
Exercise Therapy - methods
Female
Follow-Up Studies
Heart
Heart Failure - epidemiology
Heart Failure - physiopathology
Heart Failure - prevention & control
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Incidence
Incident heart failure
Male
Medical sciences
MET-minutes
Motor Activity - physiology
Older adults
Physical activity
Prognosis
Prospective Studies
Risk Assessment - methods
Survival Rate - trends
United States - epidemiology
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Summary:Abstract Background Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. Methods We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥ 65 years, free of baseline HF. Weekly metabolic equivalent task-minutes (MET-minutes), estimated using baseline total leisure-time energy expenditure, were used to categorize participants into four physical activity groups: inactive (0 MET-minutes; n = 489; reference), low (1–499; n = 1458), medium (500–999; n = 1086) and high (≥ 1000; n = 2470). Results Participants had a mean (± SD) age of 73 (± 6) years, 58% were women, and 15% African American. During 13 years of follow-up, centrally-adjudicated incident HF occurred in 26%, 23%, 20%, and 19% of participants with no, low, medium and high physical activity, respectively (trend p < 0.001). Compared with inactive older adults, age–sex–race-adjusted hazard ratios (95% confidence intervals) for incident HF associated with low, medium and high physical activity were 0.87 (0.71–1.06; p = 0.170), 0.68 (0.54–0.85; p = 0.001) and 0.60 (0.49–0.74; p < 0.001), respectively (trend p < 0.001). Only high physical activity had significant independent association with lower risk of incident HF (HR, 0.79; 95% CI, 0.64–0.97; p = 0.026). All levels of physical activity had significant independent association with lower risk of incident acute myocardial infarction (AMI), stroke and cardiovascular mortality. Conclusion In community-dwelling older adults, high level of physical activity was associated with lower risk of incident HF, but all levels of physical activity were associated with lower risk of incident AMI, stroke, and cardiovascular mortality.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2012.12.053