title: Speed and duration of walking and other leisure time physical activity and the risk of heart failure: a prospective cohort study from the Copenhagen City Heart Study.
abstract: OBJECTIVE
  Physical activity (PA) confers some protection against development of heart failure (HF) but little is known of the role of intensity and duration of exercise.
  
  
  RESULTS
  In a prospective cohort study of men and women free of previous MI, stroke or HF with one or more examinations in 1976-2003, we studied the association between updated self-assessed leisure-time PA, speed and duration of walking and subsequent hospitalization or death from HF. Light and moderate/high level of leisure-time PA and brisk walking were associated with reduced risk of HF in both genders whereas no consistent association with duration of walking was seen. In 18,209 subjects age 20-80 with 1580 cases of HF, using the lowest activity level as reference, the confounder-adjusted hazard ratios (HR) for light and moderate/high leisure-time physical activity were 0.75 (0.66-0.86) and 0.80 (0.69-0.93), respectively. In 9,937 subjects with information on walking available and 542 cases of HF, moderate and high walking speed were associated with adjusted HRs of 0.53 (0.43-0.66) and 0.30 (0.21-0.44), respectively, and daily walking of ½-1 hrs, 1-2 and >2 hrs with HR of 0.80 (0.61-1.06), 0.82 (0.62-1.06), and 0.96 (0.73-1.27), respectively. Results were similar for both genders and remained robust after exclusion of HF related to coronary heart disease and after a series of sensitivity analyses.
  
  
  CONCLUSIONS
  Speed rather than duration of walking was associated with reduced risk of HF. Walking is the most wide-spread PA and public health measures to curb the increase in HF may benefit from this information.
authors.affiliation: Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Hans Askelund
authors.initials: HA
authors.lastname: Saevereid
authors.affiliation: The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Schnohr
authors.affiliation: Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark; The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark.
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
mesh_terms: D000054:Acceleration; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013997:Time Factors; D016138:Walking / Q000502:physiology*; D055815:Young Adult