Abstract P264: Meeting
            2008 Physical Activity Guidelines for Americans
            Reduces Risk of Recurrent CVD Events in MI Survivors: The Western New York Acute MI Study (1996–2006)

Introduction: The 2008 Physical Activity Guidelines for Americans (PAG) recommend adults perform at least 150 minutes/week of moderate intensity physical activity or 75 minutes/week of vigorous intensity activity or an equivalent combination of both in order to obtain important health benefits, including lower CHD risk. Despite advances in clinical medicine, survivors of MI remain at substantial risk of recurrent cardiovascular events and death. The aim of our prospective study was to examine whether meeting the PAG reduced risk of recurrent CVD events in MI patients. Hypothesis: We hypothesized that MI survivors who met the current PAG had a more favorable prognosis than those who did not meet the guidelines. Methods: Incident MI cases (933 men, 354 women, 35–69 years old) recruited from 12 of 15 Western NY hospitals completed an interviewer-administered survey and clinic exam. Physical activity (PA) in the previous seven days was assessed using the Stanford 7-day PA recall. Minutes reported in moderate and vigorous intensity recreational, household and occupational activity (MVPA) were summed and participants were categorized as follows (min/week): inactive (0), insufficiently active (>0–<150), met (150–300), and exceeded the guideline goal (>300). Participant surveys, medical records and a search of the National Death Index Plus were used to determine fatal and non-fatal recurrent CVD (ICD9 390–450) events. Cox regression analysis adjusting for age (in years), gender, education (in years), race, BMI, smoking status, hypertension and use of diabetes and lipid medication was conducted to examine the association between PA and recurrent events. Results: During a mean follow up of 4.1 years, 301 recurrent CVD events occurred. At baseline, 174 (13.5%) participants reported no MVPA, 216 (16.8%) were insufficiently active, whereas 259 (20.1%) met and 638 (49.6%) exceeded the PAG, respectively. Multivariate adjusted hazard ratios (95% CI) for recurrent CVD events were Inactive [Ref (1.00)], insufficiently active [0.68 (0.46–1.01)], met [0.63 (0.43–0.92)], and exceeded the guideline goal [0.63 (0.45–0.87)], p-trend =0.019. Conclusion: In this prospective population-based study, there is evidence to support that meeting the 2008 Physical Activity Guidelines for Americans has significant benefits on fatal and non-fatal recurrent CVD events in men and women following myocardial infarction.

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Leisure-Time Physical Activity and Disability Retirement: A Prospective Cohort Study

Journal of Physical Activity and Health ◽

10.1123/jpah.10.5.669 ◽

2013 ◽

Vol 10 (5) ◽

pp. 669-675 ◽

Cited By ~ 14

Author(s):

Jouni Lahti ◽

Ossi Rahkonen ◽

Eero Lahelma ◽

Mikko Laaksonen

Keyword(s):

Physical Activity ◽

Leisure Time ◽

Cox Regression ◽

Leisure Time Physical Activity ◽

Moderate Intensity ◽

Vigorous Exercise ◽

Cox Regression Analysis ◽

Disability Retirement ◽

Moderate Intensity Physical Activity ◽

Reduced Risk

Background:To examine whether leisure-time physical activity is associated with all-cause disability retirement as well as disability retirement due to musculoskeletal and mental causes.Methods:The baseline data were collected by questionnaire surveys in 2000−2002 among 40- to 60-year-old employees of the City of Helsinki. Disability retirement data were derived from the registry of the Finnish Centre for Pensions (maximum follow-up time 6.8 years). The analysis included 4920 women and 1355 men. Physical activity was converted to metabolic equivalent (MET) index. We classified the participants into 4 groups according to physical activity recommendations and according to the participation in vigorous intensity activities. Cox regression analysis was used to calculate hazard ratios.Results:Physical activity decreased the risk of all-cause disability retirement among both genders, however, women engaging in recommended volume of moderate-intensity activity only did not have reduced risk. Those engaging in vigorous activity with sufficient total volume had clearly reduced risk of disability retirement. The association was similar when examining disability retirement due to musculoskeletal and mental causes.Conclusion:For healthy middle-aged engaging in moderate-intensity physical activity additional vigorous exercise may be useful for maintaining musculoskeletal and mental health and thus lower the risk of subsequent disability retirement.

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Accelerometer measured physical activity and the incidence of cardiovascular disease: Evidence from the UK Biobank cohort study

PLoS Medicine ◽

10.1371/journal.pmed.1003487 ◽

2021 ◽

Vol 18 (1) ◽

pp. e1003487

Author(s):

Rema Ramakrishnan ◽

Aiden Doherty ◽

Karl Smith-Byrne ◽

Kazem Rahimi ◽

Derrick Bennett ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Lower Risk ◽

Cox Regression ◽

Moderate Intensity ◽

Inverse Association ◽

Uk Biobank ◽

Reverse Causality ◽

Vigorous Intensity ◽

The Uk

Background Higher levels of physical activity (PA) are associated with a lower risk of cardiovascular disease (CVD). However, uncertainty exists on whether the inverse relationship between PA and incidence of CVD is greater at the highest levels of PA. Past studies have mostly relied on self-reported evidence from questionnaire-based PA, which is crude and cannot capture all PA undertaken. We investigated the association between accelerometer-measured moderate, vigorous, and total PA and incident CVD. Methods and findings We obtained accelerometer-measured moderate-intensity and vigorous-intensity physical activities and total volume of PA, over a 7-day period in 2013–2015, for 90,211 participants without prior or concurrent CVD in the UK Biobank cohort. Participants in the lowest category of total PA smoked more, had higher body mass index and C-reactive protein, and were diagnosed with hypertension. PA was associated with 3,617 incident CVD cases during 440,004 person-years of follow-up (median (interquartile range [IQR]): 5.2 (1.2) years) using Cox regression models. We found a linear dose–response relationship for PA, whether measured as moderate-intensity, vigorous-intensity, or as total volume, with risk of incident of CVD. Hazard ratios (HRs) and 95% confidence intervals for increasing quarters of the PA distribution relative to the lowest fourth were for moderate-intensity PA: 0.71 (0.65, 0.77), 0.59 (0.54, 0.65), and 0.46 (0.41, 0.51); for vigorous-intensity PA: 0.70 (0.64, 0.77), 0.54 (0.49,0.59), and 0.41 (0.37,0.46); and for total volume of PA: 0.73 (0.67, 0.79), 0.63 (0.57, 0.69), and 0.47 (0.43, 0.52). We took account of potential confounders but unmeasured confounding remains a possibility, and while removal of early deaths did not affect the estimated HRs, we cannot completely dismiss the likelihood that reverse causality has contributed to the findings. Another possible limitation of this work is the quantification of PA intensity-levels based on methods validated in relatively small studies. Conclusions In this study, we found no evidence of a threshold for the inverse association between objectively measured moderate, vigorous, and total PA with CVD. Our findings suggest that PA is not only associated with lower risk for of CVD, but the greatest benefit is seen for those who are active at the highest level.

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Does Participation in Recommended Levels of Vigorous-Intensity Physical Activity Decrease Participation in Moderate-Intensity Physical Activity?

Journal of Physical Activity and Health ◽

10.1123/jpah.1.1.45 ◽

2004 ◽

Vol 1 (1) ◽

pp. 45-55 ◽

Cited By ~ 7

Author(s):

Gavin McCormack ◽

Billie Giles-Corti

Keyword(s):

Physical Activity ◽

Moderate Intensity ◽

Compensatory Response ◽

Television Watching ◽

Physical Activity Guidelines ◽

Moderate Intensity Physical Activity ◽

Intensity Physical Activity ◽

Recreational Walking ◽

Moderate Intensity Activity ◽

Vigorous Intensity

Background:The influence of participating in vigorous-intensity physical activity and associated compensatory declines in other types of physical activity in the general population has not been studied well; hence, it is unknown if participation in recommended levels of vigorous-intensity physical activity influence the likelihood of participating in recommended levels of moderate-intensity physical activity.Methods:Face-to-face interviews were conducted on healthy adults (n = 1803), 18 to 59 years of age, recruited from the top and lower quintiles of socioeconomic status within Perth, Western Australia. Data on television watching, vigorous-intensity activity, moderate-intensity activity, and walking for recreation and transport were used in the analysis. Logistic regression was used to determine whether participation in recommended levels of vigorous-intensity activity predicted participation in recommended levels of other types of physical activity and television watching.Results:After controlling for age, gender, education, and social advantage, participating in recommended levels of vigorous-intensity physical activity (≥90 min/week) was not found to be associated with walking for transport (≥150 min/week) but was found to be significantly associated (OR = 1.38, 95%CI = 1.04–1.82) with recommended levels of recreational walking (≥150 min/week). Participation in recommended levels of vigorous-intensity physical activity was associated with a reduced likelihood of watching television more than 10 hours per/week (OR = 0.71, 95%CI = 0.57–0.89).Conclusion:In those who participate in recommended levels of vigorous-intensity physical activity, there appears to be no compensatory response in other moderate-intensity activities. Given the added health benefits associated with vigorous-intensity activity, concurrent promotion of moderate and vigorous-intensity physical activity guidelines is warranted, with no evidence that participation in vigorous-intensity activity will negatively influence participation in recommended levels of moderate-intensity activity.

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Predictors of mortality in patients with hereditary hemorrhagic telangiectasia

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-020-01579-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

K. P. Thompson ◽

◽

J. Nelson ◽

H. Kim ◽

L. Pawlikowska ◽

...

Keyword(s):

Hereditary Hemorrhagic Telangiectasia ◽

Cox Regression ◽

Clinical Symptoms ◽

Vascular Malformations ◽

Smoking Status ◽

Treatment Options ◽

Gi Bleeding ◽

Cox Regression Analysis ◽

Predictors Of Mortality

Abstract Background Retrospective questionnaire and healthcare administrative data suggest reduced life expectancy in untreated hereditary hemorrhagic telangiectasia (HHT). Prospective data suggests similar mortality, to the general population, in Denmark’s centre-treated HHT patients. However, clinical phenotypes vary widely in HHT, likely affecting mortality. We aimed to measure predictors of mortality among centre-treated HHT patients. HHT patients were recruited at 14 HHT centres of the Brain Vascular Malformation Consortium (BVMC) since 2010 and followed annually. Vital status, organ vascular malformations (VMs) and clinical symptoms data were collected at baseline and during follow-up (N = 1286). We tested whether organ VMs, HHT symptoms and HHT genes were associated with increased mortality using Cox regression analysis, adjusting for patient age, sex, and smoking status. Results 59 deaths occurred over average follow-up time of 3.4 years (max 8.6 years). A history of anemia was associated with increased mortality (HR = 2.93, 95% CI 1.37–6.26, p = 0.006), as were gastro-intestinal (GI) bleeding (HR = 2.63, 95% CI 1.46–4.74, p = 0.001), and symptomatic liver VMs (HR = 2.10, 95% CI 1.15–3.84, p = 0.015). Brain VMs and pulmonary arteriovenous malformations (AVMs) were not associated with mortality (p > 0.05). Patients with SMAD4 mutation had significantly higher mortality (HR = 18.36, 95% CI 5.60–60.20, p < 0.001) compared to patients with ACVRL1 or ENG mutation, but this estimate is imprecise given the rarity of SMAD4 patients (n = 33, 4 deaths). Conclusions Chronic GI bleeding, anemia and symptomatic liver VMs are associated with increased mortality in HHT patients, independent of age, and in keeping with the limited treatment options for these aspects of HHT. Conversely, mortality does not appear to be associated with pulmonary AVMs or brain VMs, for which patients are routinely screened and treated preventatively at HHT Centres. This demonstrates the need for development of new therapies to treat chronic anemia, GI bleeding, and symptomatic liver VMs in order to reduce mortality among HHT patients.

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Misreporting of Physical Activity and Sedentary Behavior in Parents-to-Be: A Validation Study across Sex

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094654 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4654

Author(s):

Tom Deliens ◽

Vickà Versele ◽

Jasper Jehin ◽

Eva D’Hondt ◽

Yanni Verhavert ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

International Physical Activity Questionnaire ◽

Moderate Intensity ◽

Strong Correlations ◽

Self Reports ◽

Vigorous Intensity ◽

Context Specific ◽

Acceptable Agreement ◽

Activity Questionnaire

This study validated the International Physical Activity Questionnaire (IPAQ) and the Context-specific Sedentary Behavior Questionnaire (CSBQ) against accelerometry among parents-to-be. Sex-differences in potential misreporting of physical activity (PA) and sedentary behavior (SB) were also investigated. Self-reported total PA (TPA), light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA), moderate-to-vigorous-intensity PA (MVPA), and SB of 91 parents-to-be (41 men and 50 women) were compared with Actigraph data according to sex. Furthermore, the extent of misreporting was compared between sexes. Strong correlations for TPA and weak-to-moderate correlations for LPA, MPA, VPA, MVPA, and SB were observed. Participants underestimated TPA by 1068 min/week (=17.8 h/week; −50%), LPA by 1593 min/week (=26.6 h/week; −83%), and SB by 428 min/week (=7.1 h/week; −11%) and overestimated MPA by 384 min/week (=6.4 h/week; +176%) and MVPA by 525 min/week (=8.8 h/week; +224%). Males overreported VPA more than females in absolute minutes per week (238 min/week, i.e., 4.0 h/week vs. 62 min/week, i.e., 1.0 h/week), whereas, in relative terms, the opposite (+850% vs. +1033%) was true. The IPAQ and CSBQ can be used with caution to estimate TPA and SB among parents-to-be considering a strong correlation but low agreement for TPA and a weak-to-moderate correlation but acceptable agreement for SB. We disadvise using these self-reports to estimate PA on the distinct intensity levels.

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Walking Cadence to Exercise at Moderate Intensity for Adults: A Systematic Review

Journal of Sports Medicine ◽

10.1155/2017/4641203 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 9

Author(s):

J. Slaght ◽

M. Sénéchal ◽

T. J. Hrubeniuk ◽

A. Mayo ◽

D. R. Bouchard

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Older Adults ◽

Leisure Activity ◽

Moderate Intensity ◽

Activity Levels ◽

Physical Activity Guidelines ◽

Aerobic Activity ◽

Physical Activity Levels

Background. Most adults choose walking as a leisure activity. However, many do not reach the international physical activity guidelines for adults, which recommend moderate intensity aerobic activity for at least 150 minutes/week in bouts of 10 minutes. Purpose. This systematic review provides an update on the walking cadence required to reach moderate intensity in adults and older adults, identifies variables associated with reaching moderate intensity, and evaluates how walking cadence intensity should be measured, but the main purpose is to report the interventions that have been attempted to prescribe walking cadence to increase time spent at moderate intensity or other outcomes for adults and older adults. Methods. SportDISCUS, Scopus, and PubMed databases were searched. We identified 3,917 articles and 31 were retained for this systematic review. Only articles written in English were included. Results. In general, 100 steps/minute is prescribed for adults to achieve moderate intensity, but older adults may require a higher cadence. Currently, few studies have explored using walking cadence prescription as an intervention to increase physical activity levels. Conclusion. Prescribing walking cadence as a way to increase physical activity levels has potential as a practical and useful strategy, but more evidence is required to assess its ability to increase physical activity levels at moderate intensity.

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Association between Objectively Measured Physical Activity and Gait Patterns in People with Parkinson’s Disease: Results from a 3-Month Monitoring

Parkinson s Disease ◽

10.1155/2018/7806574 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10

Author(s):

Micaela Porta ◽

Giuseppina Pilloni ◽

Roberta Pili ◽

Carlo Casula ◽

Mauro Murgia ◽

...

Keyword(s):

Physical Activity ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Analysis ◽

Time Slot ◽

Moderate Intensity ◽

Kinematic Parameters ◽

Gait Patterns ◽

Flexion Extension ◽

Vigorous Intensity

Background. Although physical activity (PA) is known to be beneficial in improving motor symptoms of people with Parkinson’s disease (pwPD), little is known about the relationship between gait patterns and features of PA performed during daily life. Objective. To verify the existence of possible relationships between spatiotemporal and kinematic parameters of gait and amount/intensity of PA, both instrumentally assessed. Methods. Eighteen individuals affected by PD (10F and 8M, age 68.0 ± 10.8 years, 1.5 ≤ Hoehn and Yahr (H&Y) < 3) were required to wear a triaxial accelerometer 24 h/day for 3 consecutive months. They also underwent a 3D computerized gait analysis at the beginning and end of the PA assessment period. The number of daily steps and PA intensity were calculated on the whole day, and the period from 6:00 to 24:00 was grouped into 3 time slots, using 3 different cut-point sets previously validated in the case of both pwPD and healthy older adults. 3D gait analysis provided spatiotemporal and kinematic parameters of gait, including summary indexes of quality (Gait Profile Score (GPS) and Gait Variable Score (GVS)). Results. The analysis of hourly trends of PA revealed the existence of two peaks located in the morning (approximately at 10) and in the early evening (between 18 and 19). However, during the morning time slot (06:00–12:00), pwPD performed significantly higher amounts of steps (4313 vs. 3437 in the 12:00–18:00 time slot, p<0.001, and vs. 2889 in the 18:00–24:00 time slot, p=0.021) and of moderate-to-vigorous PA (43.2% vs. 36.3% in the 12:00–18:00 time slot, p=0.002, and vs. 31.4% in the 18:00–24:00 time slot, p=0.049). The correlation analysis shows that several PA intensity parameters are significantly associated with swing-phase duration (rho = −0.675 for sedentary intensity, rho = 0.717 for moderate-to-vigorous intensity, p<0.001), cadence (rho = 0.509 for sedentary intensity, rho = −0.575 for moderate-to-vigorous intensity, p<0.05), and overall gait pattern quality as expressed by GPS (rho = −0.498 to −0.606 for moderate intensity, p<0.05) and GVS of knee flexion-extension (rho = −0.536 for moderate intensity, p<0.05). Conclusions. Long-term monitoring of PA integrated by the quantitative assessment of spatiotemporal and kinematic parameters of gait may represent a useful tool in supporting a better-targeted prescription of PA and rehabilitative treatments in pwPD.

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Abstract MP82: Exergaming and Physical Activity Guidelines- A Population-Based Study of Young Adults

Circulation ◽

10.1161/circ.129.suppl_1.mp82 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Lisa Kakinami ◽

Erin K O'Loughlin ◽

Erika N Dugas ◽

Catherine M Sabiston ◽

Gilles Paradis ◽

...

Keyword(s):

Physical Activity ◽

Young Adults ◽

Weight Status ◽

Population Based ◽

Moderate Intensity ◽

Physical Activity Guidelines ◽

Outdoor Sports ◽

The Past ◽

Active Video ◽

Fitness Training

Background: Compared to traditional non-active video games, exergaming may contribute significantly to overall daily physical activity (PA), but the association in population-based samples has not been fully explored. Objectives: To assess whether total minutes of PA per week among exergamers differs from non-exergamers, and whether the likelihood of meeting PA guidelines differs between exergamers and non-exergamers. Methods: Data were available from the 2011-2012 wave of the Nicotine Dependence in Teens (NDIT) study (n=829). Multivariable models assessed the association between exergaming with moderate, vigorous, and moderate-to-vigorous PA (MVPA) minutes in the past week, and the association between exergaming and meeting PA guidelines after adjusting for age, household income, employment status, education, weight status, and screen time. Exergaming was defined as use ≥ 1-3 times per month in the past year, and PA guidelines were defined as ≥ 150 minutes of moderately intense PA, or ≥ 75 minutes of vigorously intense PA, or a combination. Minutes of PA were measured using the well-validated International Physical Activity Questionnaire. Sex differences in exergaming use and exergaming beliefs and attitudes were also assessed. Results: In this population-based sample of young adults (mean age 24 [SD: 0.7] years, 55% female [n=455]), 18% (n=148) of the participants were exergamers (54% female, n=80). Exergaming males and females reported an average of 88.4 and 65.7 exergaming minutes in the past week, respectively. Compared to male exergamers, female exergamers were more likely to believe that exergaming is a good way to integrate PA into their lives (p<0.001), were more likely to prefer exergaming to indoor/outdoor sports (p=0.03), and were more likely to use fitness-training exergames at home (p=0.006). Perceived levels of exertion were also significantly different between male and female exergamers. The majority of male exergamers reported light (51%, n=23) or moderate (44%, n=20) exergaming exertion, whereas female exergamers reported moderate (53%, n=30), as well as light (28%, n=16) and intense (19%, n=11) exertion (p=0.02). After adjusting for covariates, male exergamers were not significantly different from male non-exergamers in total minutes of PA per week, but female exergamers reported 47 more minutes of moderate PA in the past week compared to female non-exergamers (p=0.03). There was no association between exergaming and meeting PA guidelines in either males or females. Conclusions: Exergaming contributes to moderate-intensity PA among females but not among males in this population based sample of young adults. Exergaming may therefore be an important source of PA for women, but the current landscape of exergames may be inadequate to substantially increase minutes of PA among males. Differences in attitudes toward exergaming should be further explored.

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Abstract P063: The Association Between Physical Activity and Fasting and 2-Hour Glucose in US Adults: NHANES 2013-2014

Circulation ◽

10.1161/circ.137.suppl_1.p063 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Joshua R Sparks ◽

Xuewen F Wang

Keyword(s):

Physical Activity ◽

Heart Rate ◽

Plasma Glucose ◽

Fasting Glucose ◽

Glucose Disposal ◽

Moderate Intensity ◽

Moderate Intensity Physical Activity ◽

Intensity Physical Activity ◽

Vigorous Intensity ◽

Activity Questionnaire

Background: Glucose concentrations in a fasted and during a glucose challenged state rely on different mechanisms for regulation. In a fasted state, hepatic regulation of glucose is important; while in a glucose challenged state, muscle glucose disposal becomes more important. Evidence suggests that physical activity of moderate or higher intensities can increase muscle glucose disposal during an insulin-stimulated state, but has less effect on hepatic insulin sensitivity. The purpose of this study was to examine the associations between glucose concentrations (fasting and after an oral glucose ingestion) and minutes of physical activity at moderate- and vigorous-intensity in a large population. Methods: The sample included 2,807 adults (47.4% male and 52.6% female) aged 18-80 years who participated in the National Health and Nutritional Examination Surveys (NHANES) from 2013-2014 and who did not take any diabetic medications. Minutes being physically active at moderate- and vigorous-intensities during work, and recreationally, were collected using the Physical Activity Questionnaire, which was based on the Global Physical Activity Questionnaire. Moderate-intensity physical activity was defined as any activity that caused a small increase in breathing or heart rate, while vigorous-intensity physical activity was defined as large increases in breathing or heart rate. Both intensities had to be performed for a minimum of 10 continuous minutes. Plasma glucose concentrations at fasting and 2 hours after consumption of a drink containing 75g glucose (2-hour glucose) were determined. Pearson product correlations were performed for analysis. Results: The population had 141±133 (mean±SD) minutes of moderate-intensity physical activity during work and 63±56 minutes recreationally, as well as 174±156 minutes of vigorous-intensity physical activity during work and 77±56 minutes recreationally. Minutes of vigorous-intensity physical activity performed during work was associated with 2-hour plasma glucose concentrations (r=0.15; p=0.045); this association was not affected after adjusting for age, race, and sex (p=0.049), but was no longer significant after BMI was also adjusted (p=0.059). Recreational or total minutes of vigorous-intensity physical activity, and moderate-intensity physical activity was not associated with 2-hour glucose (p>0.20). Additionally, none of the physical activity minutes was associated with fasting glucose (p>0.27). Conclusion: Self-reported vigorous-intensity physical activity during work was positively associated with 2-hour glucose, but not fasting glucose. The results are surprising. Further studies with objective physical activity measures are needed to examine the associations with fasting and 2-hour glucose.

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Abstract P495: Trends in Physical Activity Among US Older Adults With Heart Failure 2007-2016

Circulation ◽

10.1161/circ.141.suppl_1.p495 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Fan Ye ◽

Li Zhou ◽

Joseph Yeboah ◽

Peter H Brubaker ◽

Alain G Bertoni

Keyword(s):

Physical Activity ◽

Heart Failure ◽

Older Adults ◽

Vigorous Physical Activity ◽

Public Health Problem ◽

Moderate Intensity ◽

Recreational Activities ◽

Aerobic Activity ◽

Vigorous Intensity ◽

The Impact

Introduction: Heart failure (HF) is a growing public health problem which is the leading cause of hospitalization. About half of people who develop HF die within 5 years of diagnosis. Recent evidence suggests that physical inactivity may be an important risk for HF. However, the importance of physical activity in the prevention and treatment have not been adequately recognized. Self-reported physical activity can provide insights into the impact of lifestyle behaviors on mortality. The objective of this study was to determine the relationship between physical activity and HF in a nationally representative sample of United States (US) adults. Methods: The 2007-2016 National Health and Nutrition Examination Survey data collection cycles were used for this analysis. Participants aged 65 and older with HF were defined as those who answered “yes” to the question: “Has a doctor or other health professional ever told you that you had congestive HF?” Frequency and duration of self-reported moderate-intensity (“Days moderate recreational activities” and “Minutes moderate recreational activities”) and vigorous-intensity Days vigorous recreational activities” and “Minutes vigorous recreational activities”) physical activity were collected through questionnaires as well in all data cycles. We used 2018 Physical Activity Guidelines for Americans Older Adults, which recommended that most older adults (age≥65 years) participate in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week as our cut-off points for calculating moderate-to-vigorous physical activity. Results: Between 2007-2008 and 2015-2016, the percentage of US adults ≥65 years with HF increased from 2.76% to 3.69% (p=0.04). Although a similar percentage of participants who met the criteria of at least 150 minutes of moderate-intensity activity per week was noted in both groups from 2007 to 2016 (on average, HF: 56.9% vs. HF-free: 56.7%, respectively, p>0.05), more HF-free participants reported at least 75 minutes of vigorous-intensity recreational activities per week compared to HF participants in each calendar year (82.8% vs. 66.7%, 85.0% vs. 70.0%, 83.5% vs. 55.0%, 87.0% vs.75%, 85.2% vs. 63.6%, respectively, p<0.01). Additionally, among those who reported activities, older adults with HF were less than 20 times as likely to report moderate or vigorous recreational activities compared to those without HF. Conclusions: Our findings illustrate lower self-reported physical recreational activities, especially vigorous activities, in older participants who report a diagnosis of HF and more participants without HF report vigorous-intensity recreational activities. Future study should focus on understanding the physical limitations of HF patients, which is paramount in developing cardiac rehabilitation strategies to improve their function capacity.

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