Prevention of heart failure in older adults may require higher levels of physical activity than needed for other cardiovascular events

Kanan Patel, Xuemei Sui, Yan Zhang, Gregg C. Fonarow, Inmaculada B. Aban, Cynthia J. Brown, Vera Bittner, Dalane W. Kitzman, Richard M. Allman, Maciej Banach, Wilbert S. Aronow, Stefan D. Anker, Steven N. Blair, Ali Ahmed

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. Methods We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥ 65 years, free of baseline HF. Weekly metabolic equivalent task-minutes (MET-minutes), estimated using baseline total leisure-time energy expenditure, were used to categorize participants into four physical activity groups: inactive (0 MET-minutes; n = 489; reference), low (1-499; n = 1458), medium (500-999; n = 1086) and high (≥ 1000; n = 2470). Results Participants had a mean (± SD) age of 73 (± 6) years, 58% were women, and 15% African American. During 13 years of follow-up, centrally-adjudicated incident HF occurred in 26%, 23%, 20%, and 19% of participants with no, low, medium and high physical activity, respectively (trend p <0.001). Compared with inactive older adults, age-sex-race-adjusted hazard ratios (95% confidence intervals) for incident HF associated with low, medium and high physical activity were 0.87 (0.71-1.06; p = 0.170), 0.68 (0.54-0.85; p = 0.001) and 0.60 (0.49-0.74; p <0.001), respectively (trend p <0.001). Only high physical activity had significant independent association with lower risk of incident HF (HR, 0.79; 95% CI, 0.64-0.97; p = 0.026). All levels of physical activity had significant independent association with lower risk of incident acute myocardial infarction (AMI), stroke and cardiovascular mortality. Conclusion In community-dwelling older adults, high level of physical activity was associated with lower risk of incident HF, but all levels of physical activity were associated with lower risk of incident AMI, stroke, and cardiovascular mortality.

Original languageEnglish
Pages (from-to)1905-1909
Number of pages5
JournalInternational Journal of Cardiology
Volume168
Issue number3
DOIs
Publication statusPublished - Oct 3 2013

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Heart Failure
Exercise
Myocardial Infarction
Metabolic Equivalent
Independent Living
Mortality
Leisure Activities
African Americans
Energy Metabolism
Confidence Intervals
Health

Keywords

  • Incident heart failure
  • MET-minutes
  • Older adults
  • Physical activity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prevention of heart failure in older adults may require higher levels of physical activity than needed for other cardiovascular events. / Patel, Kanan; Sui, Xuemei; Zhang, Yan; Fonarow, Gregg C.; Aban, Inmaculada B.; Brown, Cynthia J.; Bittner, Vera; Kitzman, Dalane W.; Allman, Richard M.; Banach, Maciej; Aronow, Wilbert S.; Anker, Stefan D.; Blair, Steven N.; Ahmed, Ali.

In: International Journal of Cardiology, Vol. 168, No. 3, 03.10.2013, p. 1905-1909.

Research output: Contribution to journalArticle

Patel, K, Sui, X, Zhang, Y, Fonarow, GC, Aban, IB, Brown, CJ, Bittner, V, Kitzman, DW, Allman, RM, Banach, M, Aronow, WS, Anker, SD, Blair, SN & Ahmed, A 2013, 'Prevention of heart failure in older adults may require higher levels of physical activity than needed for other cardiovascular events', International Journal of Cardiology, vol. 168, no. 3, pp. 1905-1909. https://doi.org/10.1016/j.ijcard.2012.12.053
Patel, Kanan ; Sui, Xuemei ; Zhang, Yan ; Fonarow, Gregg C. ; Aban, Inmaculada B. ; Brown, Cynthia J. ; Bittner, Vera ; Kitzman, Dalane W. ; Allman, Richard M. ; Banach, Maciej ; Aronow, Wilbert S. ; Anker, Stefan D. ; Blair, Steven N. ; Ahmed, Ali. / Prevention of heart failure in older adults may require higher levels of physical activity than needed for other cardiovascular events. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 3. pp. 1905-1909.
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abstract = "Background Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. Methods We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥ 65 years, free of baseline HF. Weekly metabolic equivalent task-minutes (MET-minutes), estimated using baseline total leisure-time energy expenditure, were used to categorize participants into four physical activity groups: inactive (0 MET-minutes; n = 489; reference), low (1-499; n = 1458), medium (500-999; n = 1086) and high (≥ 1000; n = 2470). Results Participants had a mean (± SD) age of 73 (± 6) years, 58{\%} were women, and 15{\%} African American. During 13 years of follow-up, centrally-adjudicated incident HF occurred in 26{\%}, 23{\%}, 20{\%}, and 19{\%} of participants with no, low, medium and high physical activity, respectively (trend p <0.001). Compared with inactive older adults, age-sex-race-adjusted hazard ratios (95{\%} confidence intervals) for incident HF associated with low, medium and high physical activity were 0.87 (0.71-1.06; p = 0.170), 0.68 (0.54-0.85; p = 0.001) and 0.60 (0.49-0.74; p <0.001), respectively (trend p <0.001). Only high physical activity had significant independent association with lower risk of incident HF (HR, 0.79; 95{\%} CI, 0.64-0.97; p = 0.026). All levels of physical activity had significant independent association with lower risk of incident acute myocardial infarction (AMI), stroke and cardiovascular mortality. Conclusion In community-dwelling older adults, high level of physical activity was associated with lower risk of incident HF, but all levels of physical activity were associated with lower risk of incident AMI, stroke, and cardiovascular mortality.",
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AU - Sui, Xuemei

AU - Zhang, Yan

AU - Fonarow, Gregg C.

AU - Aban, Inmaculada B.

AU - Brown, Cynthia J.

AU - Bittner, Vera

AU - Kitzman, Dalane W.

AU - Allman, Richard M.

AU - Banach, Maciej

AU - Aronow, Wilbert S.

AU - Anker, Stefan D.

AU - Blair, Steven N.

AU - Ahmed, Ali

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N2 - Background Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. Methods We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥ 65 years, free of baseline HF. Weekly metabolic equivalent task-minutes (MET-minutes), estimated using baseline total leisure-time energy expenditure, were used to categorize participants into four physical activity groups: inactive (0 MET-minutes; n = 489; reference), low (1-499; n = 1458), medium (500-999; n = 1086) and high (≥ 1000; n = 2470). Results Participants had a mean (± SD) age of 73 (± 6) years, 58% were women, and 15% African American. During 13 years of follow-up, centrally-adjudicated incident HF occurred in 26%, 23%, 20%, and 19% of participants with no, low, medium and high physical activity, respectively (trend p <0.001). Compared with inactive older adults, age-sex-race-adjusted hazard ratios (95% confidence intervals) for incident HF associated with low, medium and high physical activity were 0.87 (0.71-1.06; p = 0.170), 0.68 (0.54-0.85; p = 0.001) and 0.60 (0.49-0.74; p <0.001), respectively (trend p <0.001). Only high physical activity had significant independent association with lower risk of incident HF (HR, 0.79; 95% CI, 0.64-0.97; p = 0.026). All levels of physical activity had significant independent association with lower risk of incident acute myocardial infarction (AMI), stroke and cardiovascular mortality. Conclusion In community-dwelling older adults, high level of physical activity was associated with lower risk of incident HF, but all levels of physical activity were associated with lower risk of incident AMI, stroke, and cardiovascular mortality.

AB - Background Little is known if the levels of physical activity required for the prevention of incident heart failure (HF) and other cardiovascular events vary in community-dwelling older adults. Methods We studied 5503 Cardiovascular Health Study (CHS) participants, age ≥ 65 years, free of baseline HF. Weekly metabolic equivalent task-minutes (MET-minutes), estimated using baseline total leisure-time energy expenditure, were used to categorize participants into four physical activity groups: inactive (0 MET-minutes; n = 489; reference), low (1-499; n = 1458), medium (500-999; n = 1086) and high (≥ 1000; n = 2470). Results Participants had a mean (± SD) age of 73 (± 6) years, 58% were women, and 15% African American. During 13 years of follow-up, centrally-adjudicated incident HF occurred in 26%, 23%, 20%, and 19% of participants with no, low, medium and high physical activity, respectively (trend p <0.001). Compared with inactive older adults, age-sex-race-adjusted hazard ratios (95% confidence intervals) for incident HF associated with low, medium and high physical activity were 0.87 (0.71-1.06; p = 0.170), 0.68 (0.54-0.85; p = 0.001) and 0.60 (0.49-0.74; p <0.001), respectively (trend p <0.001). Only high physical activity had significant independent association with lower risk of incident HF (HR, 0.79; 95% CI, 0.64-0.97; p = 0.026). All levels of physical activity had significant independent association with lower risk of incident acute myocardial infarction (AMI), stroke and cardiovascular mortality. Conclusion In community-dwelling older adults, high level of physical activity was associated with lower risk of incident HF, but all levels of physical activity were associated with lower risk of incident AMI, stroke, and cardiovascular mortality.

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KW - MET-minutes

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