Abstract 4107: Impact of Body-Mass Index and Vigorous Physical Activity on the Risk of Heart Failure: Insights from the Physicians’ Health Study
Background. Although obesity has been associated with heart failure (HF), data on the influence of physical activity to the risk of HF are limited, and the combined effect of excess body weight and physical activity is unknown.
Methods. We used Cox proportional-hazards models to investigate the individual and combined effect of body-mass index (BMI, weight in kilograms/height in meters2) and vigorous physical activity (exercise to the point of breaking a sweat) to the incidence of HF among 21,429 men (without known coronary heart disease at baseline) in the Physicians’ Health Study (mean age, 53 years). We evaluated BMI as both a continuous (1 kg/m2) and a categorical (lean, <25, overweight, 25 to 29.9, and obese, >/=30 kg/m2) variable, and vigorous physical activity as a dichotomous variable (inactive [rarely/never] vs. active [>/=1 day/month]).
Results. During a mean follow-up of 17 years, 800 participants developed new-onset HF. After adjustment for age, hypertension, diabetes, hypercholesterol-emia, smoking, alcohol intake, physical activity, and randomized aspirin/b-carotene, a 1 kg/m2 increase in BMI was associated with an 11% (95% CI 8– 13%, p<0.0001) increase in the risk of HF. As compared with lean participants, overweight and obese participants had a corresponding 47% (95% CI 28– 71%, p<0.0001) and 3.0-fold (95% CI 2.3– 3.8-fold, p<0.0001) increase in HF risk. Compared with inactive individuals, those who were physically active had a 30% (95% CI 11 - 37%, p=0.001) decrease in HF risk. In combined multivariable analyses, lean & active men had the lowest and obese & inactive men had the highest HF risk (Table⇓). The results remained robust after additional adjustment for interim myocardial infarction as a time-dependent variable.
Conclusions. In this cohort of men, elevated BMI was associated with an increased risk and vigorous physical activity was associated with a decreased risk of HF. Curtailing obesity and promoting physical activity may limit the scourge of HF.