Elevated body mass index associated with increased heart failure risk, and vigorous physical activity associated with decreased heart failure risk in males
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Although an elevated body mass index (BMI) in the obese range (≥30 kg/m2) has been associated with excess risk of heart failure (HF), the impact of overweight or preobese status and physical activity as well as their joint effect on HF are still unclear. A prospective cohort of 21,094 men without known coronary heart disease at baseline participating in the Physicians’ Health Study was assessed in order to examine the individual and combined effects of BMI and vigorous physical activity on HF incidence between 1982 and 2007. Multivariable analyses revealed that every 1-kg/m2 increase in BMI was associated with an 11% increase in HF risk. Overweight participants had a 49% increase and obese participants a 180% increase in HF risk as compared with lean participants, whilst vigorous physical activity conferred an 18% decrease in HF risk. Lean active men had the lowest and obese inactive men the highest risk of HF, the hazard ratios compared with lean active men being 1.19 for lean inactive, 1.49 for overweight active, 1.78 for overweight inactive, 2.68 for obese active and 3.93 for obese inactive men. In conclusion, elevated BMI appears to be associated with increased HF risk in males, even in the preobese range, whilst vigorous exercise is associated with a decreased HF risk. Public health measures to curtail excess weight, to maintain optimal weight, and to promote physical activity may limit the HF scourge.
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