Sedentary, Less Active Older Men at Greater Risk of HF

Marlene Busko

January 30, 2014

PASADENA, CA — A large study of men in California over age 45 found that being very sedentary outside of working hours and not spending much time doing moderate to intense physical activities were both associated with a higher risk of developing HF[1].

The study was published in the January 2014 issue of Circulation: Heart Failure.

In 7.8 years of follow-up, after researchers controlled for covariates, men who were the least physically active had a 1.52-times increased risk of developing HF, and men who were the most sedentary had a 1.34-times increased risk of HF, compared with men who were the most physically active or the least sedentary, respectively.

The associations would likely be similar in women, lead author Dr Deborah Rohm Young (Kaiser Permanente Southern California, Pasadena) told heartwire . "It's a two-pronged message: 'Sit less, move more,' and 'Follow the recommendation of the US national guidelines of 150 minutes of moderate physical activity a week,' " she said.

According to the American Heart Association, half of the people who develop heart failure will die within five years, Young noted. This study suggests that physical activity and sedentary time may be important intervention targets for preventing HF.

Are Couch Potatoes at Greater Risk of HF?

Although studies are beginning to show how being very sedentary has a detrimental effect on cardiovascular outcomes independent of physical activity, the effect on HF is not clear, the authors write. In addition, most previous studies of physical activity and its potential protective effect on HF have been done in white subjects.

The researchers analyzed data from 82 695 ethnically and racially diverse men who were aged 45 to 69 in January 2000 and covered by Kaiser Permanente Health plans in California and participated in the California Men's Health Study. The men answered questionnaires asking about sociodemographic characteristics as well as levels of activity.

Sedentary time was determined by responses to the question "Outside of work, how many hours a day do you spend watching television, sitting at a computer, or reading?" The participants were classed into three categories: <2, 3 to 4, or >5 hours a day of sedentary activity.

Participants were also asked to check off how often they had participated in 17 moderate and vigorous intensity activities in the past month, and based on their responses, they were classed into tertiles: <470 , 471–1584, and >1585 metabolic equivalent (MET) minutes of physical activity a week.

During follow-up, 3473 men were diagnosed with HF.

Men who sat for five or more hours a day (apart from sitting at work) and got little exercise had a 2.2-times greater risk of HF compared with men who sat for two hours or less and were very physically active.

Slightly more than one in 10 participants (13.2%) had CHD at baseline. Low levels of physical activity conferred an increased risk of HF in men with or without existing CHD. However, being very sedentary was linked with a significantly increased risk of HF only among men with no preexisting CHF—possibly because the sample size of men with CHF was too small, the authors write.

The study had limited power to detect significant associations between physical activity or sedentary time and HF among black or Asian men, the authors note. However, they did find a similar risk of HF from being sedentary and less active among white and Hispanic men.

The study did not examine whether the men worked in sedentary jobs or were retired or whether they participated in low-intensity activities such as walking, and the data were based on self-reports, Young acknowledged.

The study was funded by a grant from the California Cancer Research Program. The cohort was established by Kaiser Permanente Northern California Community Benefit Program. Analyses were supported by the Kaiser Permanente Southern California Community Benefit Program. The authors have no conflicts of interest.

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