Abstract 19444: Physical Activity and Heart Failure Incidence Among Postmenopausal Women in the Women’s Health Initiative Study
Background: Heart failure (HF) imposes a growing burden to public health, disproportionately affecting adults 65 years and older. Physical activity (PA) has been associated with lower HF risk in middle-aged adults or men, but this association has not been evaluated in older women. We examined this relationship in a prospective cohort of postmenopausal women and stratified results to evaluate potentially high risk groups for future targeted interventions.
Methods: Participants were 149,987 women who at baseline (1993-1998) were 50-79 years old and without known HF. Cases of HF were ascertained annually by mailed survey and adjudicated using standardized methods. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for incident HF in relation to self-reported total recreational PA examined categorically (Inactive [referent] 0 MET-hr/wk, and incremental PA tertiles: >0-7.24, 7.25-17.0, >17.0 MET-hr/wk) adjusting for study arm, age, race-ethnicity, difficulty walking one block, sociodemographic factors and major clinical HF risk factors.
Results: There were 3,329 incident cases of HF during 1.2 million person-years follow-up. Compared to inactive women, HR (95% CI) for incident HF across incremental PA tertiles were 0.94 (0.86, 1.03), 0.85 (0.77, 0.94) and 0.78 (0.69, 0.87), trend p<0.001. Results were unchanged with further adjustment for baseline history of CHD, atrial fibrillation, hormone therapy use, and cancer. Excluding women who reported at baseline difficulty walking one block only slightly strengthened the association (HR = 1.00, 0.88, 0.79, 0.74, trend p<0.001). In stratified analyses, significant inverse patterns of association were similar among race-ethnic groups (interaction p=0.76) and in women with and without baseline hypertension (interaction p=0.94). The inverse association was stronger in women ≤60 compared to >60 years (interaction p=0.002). A significant inverse association was seen in women without but not in those with history of CHD at baseline (interaction p=0.007).
Conclusion: Among postmenopausal women, self-reported total recreational PA was associated with significantly lower risk of HF. The influence prior CHD has on this association requires further understanding.
Author Disclosures: M.J. LaMonte: None. J.C. Larson: None. J.E. Manson: None. A.K. Chomistek: None. W. Li: None. J.W. Bea: None. C.E. Lewis: None. K.C. Johnson: None. J. Wactawski-Wende: None. C.B. Eaton: None.
- © 2016 by American Heart Association, Inc.