Reduced risk of heart failure in active older women

A new study found that postmenopausal women who exercised more intensively, even while walking, were less likely to develop heart failure (CHF).

According to the observational analysis, women with increasing amounts of total physical activity – measured in metabolic equivalent tertiles (MET) – hours per week (> 0-7,2, 7,3-17,0 and> 17.0) – had a reduced overall HF. risk (HR 0.89, 0.74, 0.65, trend P<0.001) compared to women who had no work hours per week of activity, reported Michael LaMonte, PhD, MPH, of the University of Buffalo in New York, and their colleagues from JACC: heart failure.

These associations were observed both in patients with IC with a preserved ejection fraction (HFpEF; HR 0.93, 0.70, 0.68, P<0.001) and HF patients with reduced ejection fraction (HFrEF; HR 0.81, 0.59, 0.68, P= 0.01).

Investigators also assessed less rigorous forms of exercise, such as walking, which were also inversely related to the overall risk of HF (DR 0.98, 0.93, 0.72, P<0.001), HFpEF risk (HR 0.98, 0.87, 0.67, P<0.001) and the HFrEF risk (HR 0.75, 0.78, 0.67, P= 0.01) compared to women who did not report walking hours per week of walking.

"Our results clearly show that higher levels of self-reported total physical activity (assessed by questionnaire) are associated with significantly lower risks of developing overall heart failure and each subtype," LaMonte said. MedPage today. "We also show that walking, which is the most frequently reported leisure activity in the elderly, confers similar benefits to reduce the risks of heart failure."

Kelley Pettee Gabriel, PhD, from the University of Texas at Austin, explained that "the physical activity you do is more important than physical activity at a certain level of effort or intensity." MedPage today. "This is important for older people who can not participate in gentler physical activities."

"These findings confirm the idea that it's never too late in life to become more physically active, and clinicians should encourage walking at any age," said Gabriel, who n & # 39; 39; was not involved in the study.

But in an accompanying editorial, Mariell Jessup, MD, scientific and medical director of the American Heart Association, and Nosheen Reza, MD, of the University of Pennsylvania in Philadelphia, warned that "take a closer look at the data use physical activity as a prescription for older women.

They pointed out that "multivariate models were calculated with increasing control for confusion, and then included potential HF mediators; the model selection strategies for adjusting standard risk factors are not articulated.

In addition, the investigators did not "present the detailed output parameters of their models, which makes it difficult to understand the statistical and clinical significance of the covariates of the components, or the overall degree of overshoot or underperformance. ", wrote Jessup and Reza.

Researchers evaluated the exercise levels and prevalence of HF in 137,303 postmenopausal women (aged 50 to 79 years) and a subgroup of 35,272 women in whom HFpEF and HFrEF were specifically reported. . Over a 14-year follow-up period, there were 2,523 cases of IC in the largest cohort and 451 cases of HFrEF and 734 of HFpEF in the small subgroup.

Comparing those who did not practice with those who did not, the researchers found that the incidence of HF (per 1,000 person-years) was 2.9 compared with 1.8 for CI, 1 , 2 against 0.8 for HFrEF and 1.7 against 1.3 for HFpEF.

The evaluation of continuous exposure, for an estimated duration of 60 minutes per week of brisk walking, resulted in a risk reduction of 9%, 10% and 8%, respectively, of IC , HFrEF and HFpEF.

The LaMonte group cited information about self-reported exercises as a limitation of their dataset and that participants are not a faithful representation of the US women's cross section. And the subgroup analyzes, they explained, were done on a smaller sample and the results should therefore be evaluated accordingly.

Jessup and Reza also mentioned "the lack of additional potential mediating factors such as atrial fibrillation, diabetes, hypertension and the lack of direct measurement of cardiorespiratory fitness, which is a predictor of adverse cardiovascular effects. . . "

2018-09-05T17: 39: 31-0400