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Original Article

Dose-Response Relations of Total and Leisure-Time Physical Activity to Risk of Heart Failure: A Prospective Cohort Study

Kasper Andersen, Daniela Mariosa, Hans-Olov Adami, Claes Held, Erik Ingelsson, Ylva Trolle Lagerros, Olof Nyren, Weimin Ye, Rino Bellocco, Johan Sundström
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https://doi.org/10.1161/CIRCHEARTFAILURE.113.001010
Circulation: Heart Failure. 2014;CIRCHEARTFAILURE.113.001010
Originally published September 2, 2014
Kasper Andersen
Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
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  • For correspondence: kasper.andersen@medsci.uu.se
Daniela Mariosa
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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Hans-Olov Adami
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Epidemiology, Harvard School of Public Health, Boston, MA
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Claes Held
Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
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Erik Ingelsson
Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Ylva Trolle Lagerros
Unit of Clinical Epidemiology, Karolinska Institutet, Solna, Sweden
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Olof Nyren
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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Weimin Ye
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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Rino Bellocco
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Statistics, University of Milano-Bicocca, Milan, Italy
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Johan Sundström
Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden
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Abstract

Background—The nature of the association between levels of physical activity and risk of heart failure is little known. We investigated non-linear associations of total and leisure-time physical activity with risk of heart failure.

Methods and Results—In 1997, 39,805 persons without heart failure completed a questionnaire of lifestyle factors and medical history. We used Cox regression models to investigate total (adjusting for education and previous myocardial infarction) and direct (multivariable-adjusted) effects of self-reported total and leisure-time physical activity on risk of heart failure of any cause and heart failure of non-ischemic origin. Heart-failure diagnoses were obtained until December 31, 2010. Higher leisure-time physical activity was associated with lower risk of heart failure of any cause; hazard ratio (HR) of the total effect of leisure time physical activity was for fifth vs. first quintile 0.54; 95% confidence interval (CI) 0.44-0.66. The direct effect was similar. High total daily physical activity level was associated with lower risk of heart failure, although the effect was less pronounced than for leisure-time physical activity (total effect HR 0.81; 95% CI 0.69-0.95; fifth vs. first quintile). A similar direct effect observed.

Conclusions—Leisure-time physical activity was inversely related to risk of developing heart failure in a dose-response fashion. This was reflected in a similar but less pronounced association of total physical activity with risk of heart failure. Only part of the effects appeared to be mediated by traditional risk factors.

  • epidemiology
  • heart failure
  • physical exercise
  • cohort study
  • primary prevention
  • Received November 26, 2013.
  • Accepted July 1, 2014.
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Circulation: Heart Failure
April 2018, Volume 11, Issue 4
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    Dose-Response Relations of Total and Leisure-Time Physical Activity to Risk of Heart Failure: A Prospective Cohort Study
    Kasper Andersen, Daniela Mariosa, Hans-Olov Adami, Claes Held, Erik Ingelsson, Ylva Trolle Lagerros, Olof Nyren, Weimin Ye, Rino Bellocco and Johan Sundström
    Circulation: Heart Failure. 2014;CIRCHEARTFAILURE.113.001010, originally published September 2, 2014
    https://doi.org/10.1161/CIRCHEARTFAILURE.113.001010

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    Dose-Response Relations of Total and Leisure-Time Physical Activity to Risk of Heart Failure: A Prospective Cohort Study
    Kasper Andersen, Daniela Mariosa, Hans-Olov Adami, Claes Held, Erik Ingelsson, Ylva Trolle Lagerros, Olof Nyren, Weimin Ye, Rino Bellocco and Johan Sundström
    Circulation: Heart Failure. 2014;CIRCHEARTFAILURE.113.001010, originally published September 2, 2014
    https://doi.org/10.1161/CIRCHEARTFAILURE.113.001010
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