Abstract 17425: Physical Activity and Incident Heart Failure in High-Risk Subgroups
Background: While physical activity (PA) is crucial for coronary heart disease (CHD) prevention, it is unclear if PA prevents the onset of HF after CHD is already established. In contrast, PA may be more effective for HF prevention in other subgroups defined as high risk for HF (obesity, diabetes, hypertension and the metabolic syndrome).
Hypothesis: We hypothesized that PA is less strongly associated with reduced HF risk among those with prevalent CHD than in other subgroups at high risk for HF.
Methods: We followed 12,269 ARIC participants (mean age 55 yrs; 55% female; 23% black) who were free of HF at baseline (Visit 1; 1987-89). Exercise PA was assessed using a modified Baecke questionnaire and categorized according to AHA guidelines as recommended, intermediate or poor. Prevalent CHD was self-reported at baseline. We constructed Cox models to estimate the association of each high-risk subgroup with incident HF, and to estimate the associations between higher PA and incident HF within each high-risk subgroup. We performed likelihood ratio tests to test for interactions between each high-risk subgroup and PA on the outcome of incident HF.
Results: Over a median 24 years of follow-up, there were 2,073 HF events. Each high-risk subgroup was strongly associated with incident HF (HRs ranging from 2.19 to 3.30). Compared to poor activity, recommended activity was associated with lower HF risk among participants with obesity, diabetes, hypertension, and the metabolic syndrome, but not among those with prevalent CHD (Table; HR 1.02 [95% CI: 0.71-1.46]). A significant interaction was seen between prevalent CHD and PA on HF risk (p<0.05), whereas significant interactions with PA were not seen for other high-risk subgroups.
Conclusion: PA may be less strongly associated with decreased HF risk among those with existing CHD than in other high-risk subgroups. CHD prevention should be emphasized, and further work is needed to refine strategies for reducing HF risk among CHD patients.
Author Disclosures: R. Florido: None. L. Kwak: None. M. Lazo: None. E.D. Michos: None. V. Nambi: None. R.S. Blumenthal: None. G. Gerstenblith: None. S.D. Russell: None. C.M. Ballantyne: Consultant/Advisory Board; Modest; Abbott Diagnostics, Amarin, Amgen, Eli Lilly, Esperion, Ionis, Matinas BioPharma Inc, Novartis, Regeneron, Roche Diagnostic. Research Grant; Significant; NIH, AHA, ADA. Other Research Support; Significant; Abbott Diagnostic, Amarin, Amgen, Eli Lilly, Esperion, Ionis, Novartis, Pfizer, Regeneron, Roche Diagnostic, Sanofi-Synthelabo. Consultant/Advisory Board; Significant; Astra Zeneca, Merck, Pfizer, Sanofi-Synthelabo. E. Selvin: None. A.R. Folsom: None. J. Coresh: None. C.E. Ndumele: None.
- © 2016 by American Heart Association, Inc.