Inactivity, Excess Weight Linked to Hard-to-Treat Heart Failure

DALLAS, Tex -- February 28, 2017 -- Lack of exercise and excessive weight are strongly associated with heart failure with preserved ejection fraction, according to a study published in the Journal of the American College of Cardiology (JACC).

“Previous studies have consistently found an association between low levels of physical activity, high body mass index, and overall risk of heart failure, but this study shows that the association is more pronounced for heart failure with preserved ejection fraction, the type of heart failure that is the most challenging to treat,” said Jarett Berry, MD, UT Southwestern, Dallas, Texas.

“The 5-year survival rate among heart failure with preserved ejection fraction patients is around 30% to 40%,” said Ambarsih Pandey, UT Southwestern Medical Center. “While heart failure with reduced ejection fraction survival has improved significantly over the years, heart failure with preserved ejection fraction prognosis is little changed.”

The pooled analysis looked at data from 51,000 participants in 3 cohort studies, the Women’s Health Initiative, the Multiethnic Study of Atherosclerosis (MESA), and the Cardiovascular Health Study. Among the 51,000 participants, there were 3,180 individuals who developed heart failure. Of these, 39% were heart failure with preserved ejection fraction, 29% were heart failure with reduced ejection fraction, and 32% had not been classified when the data was gathered.

The incidence of heart failure with preserved ejection fraction was 19% lower for individuals who exercised at recommended levels. Similarly, body mass index (BMI) had an inverse relationship with heart failure with preserved ejection fraction. Higher BMI levels were more strongly associated with heart failure with preserved ejection fraction than with heart failure with reduced ejection fraction.

Heart failure with preserved ejection fraction is a growing problem as the population ages, and is particularly a problem among elderly women.

Medications such as ACE inhibitors, beta blockers, and aldosterone antagonists have been shown in large-scale randomised trials to reduce mortality in patients with heart failure with reduced ejection fraction. However, clinical trials have not identified medications that reduce mortality in patients with heart failure with preserved ejection fraction.

Heart transplant is the ultimate option for some patients with heart failure with reduced ejection fraction but is not an option for patients with heart failure with preserved ejection fraction, all of which means that prevention is crucial for heart failure with preserved ejection fraction.

“These findings highlight the importance of lifestyle interventions such as increasing physical activity levels and reducing weight to combat the growing burden of this disease,” said Dr. Berry.

SOURCE: UT Southwestern Medical Center
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