Abstract 18062: Association of Leisure Time Physical Activity With Incidence of Heart Failure With Preserved and Reduced Ejection Fraction in the Million Veteran Program

Abstract

Introduction: Heart failure (HF) continues to be the leading cause of hospitalization in older men in the United States. While previous studies have reported beneficial effects of leisure time physical activity (LTPA) on cardiovascular disease, it is unclear whether LTPA is associated with incidence of HF with reduced or preserved ejection fraction (EF). The current study examined the association of LTPA with incidence of HF in US Veterans in the Million Veteran program. Methods: The MVP is a nationally representative, prospective cohort study of Veterans which started in 2011 and has currently enrolled over 900,000 participants. Self-reported vigorous, moderate, and light activity was collected at baseline and converted into hours of metabolic equivalent of task per week (MET-h/week). HF was ascertained using ICD-9 code of 428.x or ICD-10 code of I50.x. We defined incident HFpEF using ejection fraction ≥ 50% and HFrEF using ejection fraction ≤ 40%. Cox proportional hazard model was used to compute multivariable adjusted hazard ratio (HR) and 95% confidence intervals (95%). Results: Among 461,267 Veterans analyzed, the mean age was 63.9 years (SD 12.7) and 95% were men. Participants were followed for 5 years, with 25,192 new cases of HF (12,226 HFrEF and 10,422 HFpEF) occurred. In a multivariable adjusted model, LPTA was inversely associated with incident HF with HR (95% CI) of 1.00 (ref), 0.82 (0.79-0.86); 0.67 (0.63-0.71); 0.65 (0.62-0.69); and 0.50 (0.48-0.53), from the lowest to the highest quintile of LTPA, respectively, p for linear trend <0.00001. Similar inverse associations were observed for HFpEF as well as HFrEF (p<0.0001 each). Conclusion: Our data are consistent with inverse association of LTPA with incidence of HF including HFpEF and HFrEF.