Speed and Duration of Walking and Other Leisure Time Physical Activity and the Risk of Heart Failure: A Prospective Cohort Study from the Copenhagen City Heart Study

Abstract

Physical activity (PA) confers some protection against development of heart failure (HF) but little is known of the role of intensity and duration of exercise. In a prospective cohort study of men and women free of previous MI, stroke or HF with one or more examinations in 1976–2003, we studied the association between updated self-assessed leisure-time PA, speed and duration of walking and subsequent hospitalization or death from HF. Light and moderate/high level of leisure-time PA and brisk walking were associated with reduced risk of HF in both genders whereas no consistent association with duration of walking was seen. In 18,209 subjects age 20–80 with 1580 cases of HF, using the lowest activity level as reference, the confounder-adjusted hazard ratios (HR) for light and moderate/high leisure-time physical activity were 0.75 (0.66–0.86) and 0.80 (0.69–0.93), respectively. In 9,937 subjects with information on walking available and 542 cases of HF, moderate and high walking speed were associated with adjusted HRs of 0.53 (0.43–0.66) and 0.30 (0.21–0.44), respectively, and daily walking of ½–1 hrs, 1–2 and >2 hrs with HR of 0.80 (0.61–1.06), 0.82 (0.62–1.06), and 0.96 (0.73–1.27), respectively. Results were similar for both genders and remained robust after exclusion of HF related to coronary heart disease and after a series of sensitivity analyses. Speed rather than duration of walking was associated with reduced risk of HF. Walking is the most wide-spread PA and public health measures to curb the increase in HF may benefit from this information.