The association of walking pace and incident heart failure and subtypes among postmenopausal women

Moafi-Madani Miremad, Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
Xiaochen Lin, Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
Somwail Rasla, Division of General Internal Medicine, Brown University, Providence, Rhode Island, USA.
Amr El Meligy, Division of General Internal Medicine, Brown University, Providence, Rhode Island, USA.
Mary B. Roberts, Center for Primary Care and Prevention, Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, Rhode Island, USA.
Deepika Laddu, Department of Physical Therapy, University of Illinois at Chicago, Chicago, Illinois, USA.
Matthew Allison, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA.
Lisa W. Martin, Department of Medicine, George Washington University, Washington, District of Columbia, USA.
Aladdin H. Shadyab, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA.
Jo Ann Manson, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Rowan Chlebowski, Division of Medical Oncology and Hematology, University of California Los Angeles, Los Angeles, California, USA.
Gurusher Panjrath, Department of Medicine, George Washington University, Washington, District of Columbia, USA.
Michael J. LaMonte, Department of Epidemiology and Environmental Health, University of Buffalo, Buffalo, New York, USA.
Simin Liu, Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
Charles B. Eaton, Department of Epidemiology, Brown University, Providence, Rhode Island, USA.

Document Type

Journal Article

Publication Date

1-20-2022

Journal

Journal of the American Geriatrics Society

DOI

10.1111/jgs.17657

Keywords

heart failure; physical activity; postmenopausal; walking pace; women

Abstract

BACKGROUND: To investigate the association between walking pace and the risk of heart failure (HF) and HF sub-types. METHODS: We examined associations of self-reported walking pace with risk of incident HF and HF subtypes of preserved (HFpEF) and reduced (HFrEF) ejection fractions, among 25,183 postmenopausal women, ages 50-79 years. At enrollment into the Women's Health Initiative cohort in 1993-1998, this subset of women was free of HF, cancer, or the inability to walk one block, with self-reported information on walking pace and walking duration. Multivariable Cox regression was used to examine associations of walking pace (casual <2 mph [referent], average 2-3 mph, and fast >3 mph) with incident HF. We also examined the joint association of walking pace and duration with incident HF. RESULTS: There were 1455 incident adjudicated acute decompensated HF hospitalization cases during a median of 16.9 years of follow-up. There was a strong inverse association between walking pace and overall risk of HF (HR = 0.73, 95% CI [0.65, 0.83] for average vs. casual walking; HR = 0.66, 95%CI [0.56, 0.78] for fast vs. casual walking). There were similar associations of walking pace with HFpEF (HR = 0.73, 95%CI [0.62, 0.86] average vs. casual; HR = 0.63, 95%CI [0.50, 0.80] for fast vs. casual) and with HFrEF (HR = 0.72, 95%CI [0.57, 0.91] for average vs. casual; HR = 0.74, 95%CI [0.54, 0.99] for fast vs. casual). The risk of HF associated with fast walking with less than 1 h/week walking duration was comparable with the risk of HF among casual and average walkers with more than 2 h/week walking duration. CONCLUSION: Walking pace was inversely associated with risks of overall HF, HFpEF, and HFrEF in postmenopausal women. Whether interventions to increase the walking pace in older adults will reduce HF risk and whether fast pace will compensate for the short duration of walking warrants further study.

Department

Medicine

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