Body Mass Index and Vigorous Physical Activity and the Risk of Heart Failure Among Men
Key result
Elevated BMI increased heart failure risk by 11% per 1-kg/m2 (95% CI 9-13), while vigorous physical activity lowered risk; obese inactive men had the highest risk (HR 3.93; 95% CI 2.60-5.96).
Why the study?
Does elevated BMI and vigorous physical activity affect the incidence of heart failure in men without known coronary heart disease?
Population
21,094 men without known coronary heart disease at baseline in the Physicians' Health Study
Comparison
Elevated BMI and vigorous physical activity vs Lean BMI and physical inactivity
Design
Cohort
Follow-up
mean, 20.5 years
Authors
Discussion
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Member takes
Implication
May inform HF risk stratification in men; extends observational data but leaves causal effects of interventions unproven.
Key Points
- To assess the individual and combined associations of body mass index and vigorous physical activity with the long-term risk of developing heart failure in men.
- Prospective cohort study analyzing 21,094 men (mean age, 53 years) without baseline coronary heart disease from the Physicians' Health Study with a mean follow-up of 20.5 years (1982 to 2007).
- Assessed BMI continuously and categorically (lean <25 kg/m², overweight 25–29.9 kg/m², obese ≥30 kg/m²) alongside vigorous physical activity (inactive [rarely/never] vs active [≥1–3 times/month]).
- Over 20.5 years, 1,109 participants developed heart failure; each 1-kg/m² increment in BMI was associated with an 11% higher risk (95% CI, 9 to 13), with overweight and obese men having a 49% (95% CI, 32 to 69) and 180% (95% CI, 124 to 250) increased risk versus lean participants.
- Vigorous physical activity was associated with an 18% reduction in heart failure risk (95% CI, 4 to 30), with no significant interaction observed between BMI and activity level (P=0.96).
- Compared with lean active men, hazard ratios were 1.19 (95% CI, 0.94 to 1.51) in lean inactive, 1.49 (95% CI, 1.30 to 1.71) in overweight active, 1.78 (95% CI, 1.43 to 2.23) in overweight inactive, 2.68 (95% CI, 2.08 to 3.45) in obese active, and 3.93 (95% CI, 2.60 to 5.96) in obese inactive men.
Study Design
Type
Cohort (n=21,094)
Structured PICO
Does elevated BMI and vigorous physical activity affect the incidence of heart failure in men without known coronary heart disease?
P
Population
21,094 men (mean age, 53 years) without known coronary heart disease at baseline in the Physicians' Health Study
I
Intervention
Elevated BMI (overweight 25 to 29.9 kg/m2 and obese >=30 kg/m2) and vigorous physical activity (exercise to the point of breaking a sweat, >=1 to 3 times a month)
C
Comparator
Lean BMI (<25 kg/m2) and physical inactivity (rarely/never)
O
Outcome
Heart failure incidencehard clinical
Main Result
Effect estimate: 11% increase per 1-kg/m2 (95% CI 9-13)
Elevated BMI, even in the preobese range, increases the risk of heart failure, whereas vigorous physical activity decreases this risk in men.
Cite This Study
Kenchaiah et al. (2008) conducted a cohort in Heart failure (n=21,094). Body Mass Index and vigorous physical activity vs. Lean active men was evaluated on Heart failure incidence (11% increase per 1-kg/m2, 95% CI 9-13). Elevated BMI increased heart failure risk by 11% per 1-kg/m2 (95% CI 9-13), while vigorous physical activity lowered risk; obese inactive men had the highest risk (HR 3.93; 95% CI 2.60-5.96).