Physicians' Academy for Cardiovascular Education

Dose-response association between physical activity, BMI and risk of heart failure

Relationship Between Physical Activity, Body Mass Index, and Risk of Heart Failure

Literature - Pandey A, LaMonte M, Klein L, et al. - J Am Coll Cardiol 2017;69:1129–42

Main results


In a pooled analysis from 3 prospective cohort studies, a dose–response association between LTPA, BMI, and risk of HF was observed, particularly in HFpEF patients. These findings suggest that adequate LTPA and appropriate BMI control are important for the prevention of HFpEF.

Editorial comment

In his editorial article [5], Shah summarises the strengths and limitations of the study by Pandey at all. The strengths include the large sample size and number of events, the used meta-analysis methodology and physical activity categories, and the exclusion of patients who developed HF within two years of study start-up. The limitations include the lack of a causal explanation for the findings, the fact that physical activity intensity was self-reported and missing confounders. The author ends: ‘In conclusion, Pandey et al. have provided strong evidence that lack of physical activity is associated with incident HFpEF. Given the critical need to focus on primary prevention to control HFpEF at the population level, the mounting evidence of the harms of a sedentary lifestyle on the heart and extracardiac organs involved in HFpEF, and the fact that physical inactivity is a modifiable risk factor with a low-cost treatment, the time is ripe for considering patient centered HFpEF prevention programs (“huff-puff health clubs”) as a strategy to curb the HFpEF epidemic.’


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Find this article online at J Am Coll Cardiol

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