Abstract 16704: Cardiorespiratory Fitness and Incident Heart Failure: The FIT (Henry Ford ExercIse Testing) Project
Background: Prior studies have demonstrated low cardiorespiratory fitness as a strong marker for coronary heart disease. However, there is limited data investigating the association between fitness and risk of heart failure (HF).
Hypothesis: Utilizing data from the Henry Ford Exercise Testing (FIT) Project, we hypothesized that a higher level of fitness is inversely associated with incident HF.
Methods: We included 66,329 patients (53.8% males, mean age 55 years) free of HF who underwent clinician-referred exercise treadmill stress testing at Henry Ford Health System between 1991 and 2009. Incident HF was determined using ICD-9 codes from electronic medical records or administrative claims files. Cox proportional hazards models were performed to determine the independent association between fitness and incident HF.
Results: A total of 4,652 patients developed HF after a median follow-up duration of 6.8 years. Patients with incident HF were older (63 years vs 54 years, p<0.001) had higher prevalence of hypertension (83.1% vs 63.1%, p<0.001), prior coronary artery disease (CAD) (42.3% vs. 11%, p <0.001), and type II diabetes (33.8% vs. 17.9%, p<0.001). Peak metabolic equivalents of task were 9.1 and 6.3 in the non-HF and HF groups respectively. After adjustment for potential confounders, patients able to achieve ≥12 METs had an 84% lower risk of incident HF compared to those achieving <6 METs (hazard ratio 0.18 [95% CI 0.13-0.23] ; p-trend <0.001). Each 1 MET higher achieved from baseline was associated with a 17% lower risk (HR 0.83 [95% CI 0.81- 0.85]; P < 0.001) of incident HF. The relationship remained constant across age, sex, race, CAD, diabetes, and hypertension strata.
Conclusions: Our analysis suggests that higher level of fitness is associated with a lower incidence of HF independent of HF specific risk factors.
Author Disclosures: D.F. Kupsky: None. A.M. Ahmed: None. S. Sakr: None. W. Qureshi: None. C.A. Brawner: None. M.J. Blaha: None. J.K. Ehrman: None. S.J. Keteyian: None. M. Al-Mallah: None.
- © 2016 by American Heart Association, Inc.