Physical Activity and Heart Failure Risk in a Prospective Study of Men.
OBJECTIVE
This study investigated if total physical activity, as well as different types of physical activity, were associated with heart failure risk.


BACKGROUND
Physical activity has shown to be associated with reduced risks of coronary heart disease and stroke. Studies have also suggested that physical activity is associated with heart failure development.


METHODS
A study population of 33,012 men was followed from beginning of 1998 until the end of 2012. First event of heart failure was ascertained through linkage to the Swedish National Patient Register and Cause of Death Register. The data were analyzed by using Cox proportional hazards regression and Laplace regression.


RESULTS
During a mean follow-up of 13 years, we ascertained a total of 3,609 first events of heart failure. The average age at study baseline was 60 ± 9 years of age. When examining the entire study population, a U-shaped association between total physical activity and heart failure risk was detected, with both extremely high (57 metabolic equivalent [MET] h/day) and extremely low (38 MET h/day) levels of total physical activity associated with an increased risk of heart failure. When investigating different types of physical activity, we found that walking/bicycling at least 20 min/day was associated with 21% lower risk of heart failure (95% confidence interval: 0.72 to 0.87); corresponding to a median age at heart failure 8 months later for those who had actively walked or biked daily. When looking at long-term behavior of walking/bicycling, the results suggested a trend toward more recent active behavior being more related to heart failure protection than past physical activity levels.


CONCLUSIONS
This study suggests that both low levels and high levels of total physical activity, in comparison with moderate levels, could increase heart failure risk in men and that certain types of physical activity are associated with a protective effect on heart failure in men. When examining different types of physical activity, walking/bicycling at least 20 min per day was associated with the largest risk reduction of heart failure.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Iffat
I
Rahman
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: Andrea.Bellavia@ki.se.
Andrea
A
Bellavia
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Alicja
A
Wolk
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Nicola
N
Orsini
D000328:Adult; D015444:Exercise / Q000502:physiology*; D005500:Follow-Up Studies; D005544:Forecasting; D006333:Heart Failure / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
epidemiology; heart failure; physical activity