Abstract 15104: Increased Physical Activity is associated with Lower Risk of Both Heart Failure with Preserved and Reduced Ejection Fraction in the Elderly: The Framingham Heart Study
Background: Physical inactivity has been associated with increased risk of heart failure (CHF) in middle-aged individuals. We hypothesized that physical inactivity is associated with greater CHF risk in older individuals also, and that the association is consistent for both HF with preserved (HFPEF) versus reduced (HFREF) ejection fraction (EF).
Methods: We evaluated 1142 elderly participants (mean age 76 years; 62% women) from the original Framingham Heart Study cohort who had no prior myocardial infarction and who attended their 20th biennial examination at which daily physical activity (PA) was assessed using a standardized questionnaire. A continuous measure of PA, the PA index (PAI), was modeled as tertiles and related to the incidence of HF, HFPEF and HFREF on follow-up using Cox proportional hazards regression models adjusting for age- and sex, and then additionally for standard HF risk factors. Participants with HF and EF<45% vs. ≥ 45% were categorized as HFREF and HFPEF, respectively.
Results: On follow-up (mean 10 years), 250 participants developed HF, including 108 with HFPEF and 106 with HFREF (36 HF with unavailable EF). In age- and sex-adjusted models, the middle and highest PAI tertiles were associated with a 15–56% lower risk of any HF, of HFREF and of HFPEF, with a graded response across tertiles (Table). In multivariable models, the association of PAI with any HF and with HFPEF was maintained, whereas the association with HFREF was slightly attenuated (Table).
Conclusions: In our elderly community-based sample, greater physical activity was associated with lower risk of both HFPEF and HFREF. Our study extends to the elderly and to both HF types previous findings of a protective effect of physical activity on HF risk.
- © 2010 by American Heart Association, Inc.