title: Preventing heart failure: the role of physical activity.
abstract: OBJECTIVE
  Heart failure prevention is an important public health goal. Increased physical activity and exercise may help to prevent heart failure, as they are associated with reduced heart failure incidence and potentially act through a variety of mechanisms to slow disease progression.
  
  
  RESULTS
  Increased physical activity, higher cardiorespiratory fitness, and lower sedentary time are associated with reduced heart failure incidence. These associations are consistent for occurrence of heart failure with both preserved and reduced ejection fraction, the common subphenotypes of the condition. Physiologic cardiac and vascular remodeling occurs across the normal range of physical activity in the community, and regular exercise (four to five sessions per week) is necessary to mitigate age-associated reductions in ventricular compliance and cardiac mass.
  
  
  CONCLUSIONS
  Greater physical activity, less sedentary time, and improved cardiorespiratory fitness are associated with reductions in heart failure risk. Various mechanisms may explain these findings, including: reducing the prevalence of standard and novel cardiovascular risk factors, inhibiting pathologic cardiovascular remodeling, promoting physiologic remodeling, and improving cardiac, neurohormonal, skeletal muscle, pulmonary, renal, and vascular performance. Future research is needed to elucidate the optimal timing, duration, and modality of physical activity and exercise training necessary to prevent the development of heart failure.
authors.affiliation: aFramingham Heart Study, Framingham bDivision of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital cSections of Preventive Medicine & Cardiology, Boston University School of Medicine dDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Nayor
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000375:Aging / Q000502:physiology / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods / Q000523:psychology; D017079:Exercise Tolerance; D006293:Health Promotion / Q000379:methods*; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D009043:Motor Activity / Q000502:physiology*; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D013318:Stroke Volume; D020257:Ventricular Remodeling / Q000502:physiology