Effects of physical activity and sedentary time on the risk of heart failure
Open accessAbstract
Background—: Although the benefits of physical activity for risk of coronary heart disease are well established, less is known about its effects on heart failure (HF). The risk of prolonged sedentary behavior on HF is unknown. Methods and Results—: The study cohort included 82 695 men aged ≥45 years from the California Men’s Health Study without prevalent HF who were followed up for 10 years. Physical activity, sedentary time, and behavioral covariates were obtained from questionnaires, and clinical covariates were determined from electronic medical records. Incident HF was identified through International Classification of Diseases, Ninth Revision codes recorded in electronic records. During a mean follow-up of 7.8 years (646 989 person-years), 3473 men were diagnosed with HF. Controlling for sedentary time, sociodemographics, hypertension, diabetes mellitus, unfavorable lipid levels, body mass index, smoking, and diet, the hazard ratio (95% confidence interval [CI]) of HF in the lowest physical activity category compared with those in the highest category was 1.52 (95% CI, 1.39–1.68). Those in the medium physical activity category were also at increased risk (hazard ratio, 1.17 [95% CI, 1.06–1.29]). Controlling for the same covariates and physical activity, the hazard ratio (95% CI) of HF in the highest sedentary category compared with the lowest was 1.34 (95% CI, 1.21–1.48). Medium sedentary time also conveyed risk (hazard ratio, 1.13 [95% CI, 1.04–1.24]). Results showed similar trends across white and Hispanic subgroups, body mass index categories, baseline hypertension status, and prevalent coronary heart disease. Conclusions—: Both physical activity and sedentary time may be appropriate intervention targets for preventing HF.
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Early primary prevention strategies and treatment of associated risk factors reduce incident, symptomatic heart failure.
“Early primary prevention strategies and treatment of associated risk factors reduce incident, symptomatic heart failure and should include lifestyle intervention with nutrition, physical activity, weight management, and smoking cessation (271-274) (Fig. 10.6).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [272]
The Results (page not provided) report fewer incident heart-failure diagnoses among men with higher physical activity, supporting the physical-activity aspect of prevention. The Clinical Perspective (page not provided) describes this as an association and says whether changing these behaviors affects risk remains for future study. The paper does not establish that early prevention strategies or treatment of associated risk factors reduce symptomatic heart failure. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEarly primary prevention strategies and treatment of associated risk factors reduce incident, symptomatic heart failure.
“Early primary prevention strategies and treatment of associated risk factors reduce incident, symptomatic heart failure and should include lifestyle intervention with nutrition, physical activity, weight management, and smoking cessation (268–271) (Fig. 10.5).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [269]
The Results and Clinical Perspective report that lower physical activity was associated with higher incidence of heart failure in a cohort of middle-aged and older men. The paper does not establish that early prevention strategies or treatment of associated risk factors reduce symptomatic heart failure; it says whether changing these behaviors affects risk remains for future study. (LLM, conf=0.86)
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- Authors
- Young, D. R., Reynolds, K., Sidell, M., Brar, S., Ghai, N. R., Sternfeld, B., Jacobsen, S. J., Slezak, J. M., Caan, B., & Quinn, V. P.
- Affiliations
- Kaiser Permanente (US)
- ORCID
- Venue
- Circulation: Heart Failure
- Published
- 2014-01
- Volume
- 7
- Issue
- 1
- Pages
- 21-27
- ISSN
- 1941-3289 (ISSN-L)
- 1941-3297
- OpenAlex
- W2155932467
- Cited by
- 125
- References
- 42
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 7 · 2023: 8 · 2022: 15 · 2021: 9 · 2020: 13 · 2019: 4 · 2018: 11 · 2017: 13 · 2016: 8 · 2015: 16 · 2014: 5
- FWCI
- 9.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kaiser Permanente
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- heart failure, physical activity, sedentary behavior, sedentary time, heart failure risk, men, coronary artery disease, Hispanic subgroups, body mass index, hypertension, diabetes mellitus
- MeSH terms
- Adult, Aged, California, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Motor Activity, Surveys and Questionnaires, Risk Factors, Time Factors, Cohort Studies, Incidence, Racial Groups, Sedentary Behavior
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