Accelerated Physical Activity Found to Shield Older Women from Heart Failure in new study

In a bid to enhance public health in the 21st century, the spotlight is now on preventing heart failure (HF), and a groundbreaking study sheds light on a potentially transformative approach. The Objective Physical Activity and Cardiovascular Health (OPACH) in Older Women study, conducted from March 2012 to April 2014, reveals a compelling link between accelerometer-measured physical activity (PA), sedentary time, and incident HF in older women, offering insights into HF subtypes—preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF).

The study results were published in the journal JAMA Cardiology.

Heart failure (HF) poses a significant challenge for the aging US population, especially impacting women, older adults, and diverse groups. The lack of clear therapies for preserved EF (HFpEF) underscores the importance of HF prevention. The Objective Physical Activity and Cardiovascular Health (OPACH) study aims to address these gaps, utilizing accelerometer-measured physical activity to explore associations with incident overall HF, HFpEF, and HFrEF in older women. The study's hypothesis suggests that higher physical activity levels are associated with reduced HF risk, while increased sedentary time correlates with higher HF risk.

The cohort, consisting of 5951 women aged 63 to 99 years without known HF, embarked on a seven-day journey with hip-worn triaxial accelerometry. Follow-up for incident HF extended through February 2022, unraveling a wealth of data and associations. The study, analyzing various facets of daily PA such as total, light, and moderate to vigorous PA (MVPA), along with steps taken, and sedentary behavior including total sedentary time and mean bout duration, delivers nuanced insights into HF prevention.

Findings:

• Among the racially and ethnically diverse cohort—comprising non-Hispanic Black, Hispanic, and non-Hispanic White women—407 HF cases surfaced during an average follow-up of 7.5 years, with 257 classified as HFpEF and 110 as HFrEF.
• The study's fully adjusted hazard ratios (HRs) underscore the impact of physical activity on HF prevention.
• A 1-standard deviation increment in minutes per day of total PA yielded striking HRs of 0.85 (95% CI, 0.75-0.95) for overall HF, 0.78 (95% CI, 0.67-0.91) for HFpEF, and 1.02 (95% CI, 0.81-1.28) for HFrEF.
• Steps per day and total sedentary time also exhibited significant associations with HF subtypes.
• The study's cubic spline curves paint a vivid picture, emphasizing the significance of total PA and steps per day.
• An inverse relationship is evident, indicating that increased physical activity correlates with a decreased risk of overall HF and HFpEF.
• Conversely, total sedentary time showed a positive association, underlining the potential risks of prolonged inactivity.
• Light PA and MVPA emerged as champions in the fight against HF, showcasing inverse associations with overall HF and HFpEF.

This underscores the role of various intensities of physical activity in preventing heart failure among older women. These findings carry profound implications, suggesting that a strategic focus on increasing physical activity and reducing sedentary time could serve as a formidable strategy for primary HFpEF prevention. As discussions surrounding heart failure prevention gain momentum in public health, this study provides actionable insights that could significantly impact cardiovascular resilience and foster healthy aging among older women.

Further reading: LaMonte MJ, LaCroix AZ, Nguyen S, et al. Accelerometer-Measured Physical Activity, Sedentary Time, and Heart Failure Risk in Women Aged 63 to 99 Years. JAMA Cardiol. Published online February 21, 2024. doi:10.1001/jamacardio.2023.5692