Abstract 16992: Changes in Physical Activity and the Risk of Incident Heart Failure: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Background: Higher physical activity is associated with a lower risk of heart failure (HF). The effects of changes in physical activity levels over time on HF risk are largely uncharacterized. Hypothesis: We hypothesized that persistently recommended and increasing levels of physical activity over a 6-year period are associated with reduced HF risk. Methods: We evaluated 11,185 ARIC participants (mean age 60; 57% female, 23% black) free of CVD at Visit 3 (1993-95) with available physical activity data at Visit 1 (1987-89) and Visit 3. Exercise physical activity was assessed using a modified Baecke questionnaire and categorized according to AHA recommendations: recommended (≥150 min/wk of moderate + vigorous activity or ≥75 min/wk of vigorous activity); intermediate (1-149 min/wk of moderate + vigorous activity or 1-74 min/wk of vigorous activity); or poor (no moderate or vigorous activity). We created cross-categories of physical activity at Visit 1 and Visit 3. The primary outcome was incident HF occurring after Visit 3 through 12/31/12. We constructed Cox regression models to estimate the hazard ratios and 95% CIs for incident HF associated with each cross-category of physical activity at Visit 1 and Visit 3, adjusting for confounders. Results: Over a median of 18 years, there were 1,625 HF events. Compared to those with poor activity at both visits (reference), those with persistently recommended activity had the lowest HF risk (Table; HR 0.67 95% CI: 0.58-0.78). Additionally, at each level of baseline physical activity, increasing physical activity over time was associated with decreased HF risk: an increase from poor to recommended activity was linked to a 22% lower risk of HF. Conclusion: While maintaining recommended activity levels is associated with the lowest HF risk, initiating and increasing physical activity over time is also linked to risk reduction. Augmenting physical activity in middle age may be an important component of strategies to prevent HF.