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Aerobic fitness, muscular strength and obesity in relation to risk of heart failure

Crump, Casey LU ; Sundquist, Jan LU ; Winkleby, Marilyn A. LU and Sundquist, Kristina LU (2017) In Heart 103(22). p.1780-1787
Abstract

Objective Low physical fitness and obesity have been associated with higher risk of developing heart failure (HF), but their interactive effects are unknown. Elucidation of interactions among these common modifiable factors may help facilitate more effective primary prevention. Methods We conducted a national cohort study to examine the interactive effects of aerobic fitness, muscular strength and body mass index (BMI) among 1 330 610 military conscripts in Sweden during 1969-1997 (97%-98% of all 18-year-old men) on risk of HF identified from inpatient and outpatient diagnoses through 2012 (maximum age 62 years). Results There were 11 711 men diagnosed with HF in 37.8 million person-years of follow-up. Low aerobic fitness, low muscular... (More)

Objective Low physical fitness and obesity have been associated with higher risk of developing heart failure (HF), but their interactive effects are unknown. Elucidation of interactions among these common modifiable factors may help facilitate more effective primary prevention. Methods We conducted a national cohort study to examine the interactive effects of aerobic fitness, muscular strength and body mass index (BMI) among 1 330 610 military conscripts in Sweden during 1969-1997 (97%-98% of all 18-year-old men) on risk of HF identified from inpatient and outpatient diagnoses through 2012 (maximum age 62 years). Results There were 11 711 men diagnosed with HF in 37.8 million person-years of follow-up. Low aerobic fitness, low muscular strength and obesity were independently associated with higher risk of HF, after adjusting for each other, socioeconomic factors, other chronic diseases and family history of HF. The combination of low aerobic fitness and low muscular strength (lowest vs highest tertiles) was associated with a 1.7-fold risk of HF (95% CI 1.6 to 1.9; p<0.001; incidence rates per 100 000 person-years, 43.2 vs 10.8). These factors had positive additive and multiplicative interactions (p<0.001) and were associated with increased risk of HF even among men with normal BMI. Conclusions Low aerobic fitness, low muscular strength and obesity at the age of 18 years were independently associated with higher risk of HF in adulthood, with interactive effects between aerobic fitness and muscular strength. These findings suggest that early-life interventions may help reduce the long-term risk of HF and should include both aerobic fitness and muscular strength, even among persons with normal BMI.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
body mass index, heart failure, muscle strength, obesity, physical fitness
in
Heart
volume
103
issue
22
pages
8 pages
publisher
BMJ Publishing Group
external identifiers
  • scopus:85032715422
  • wos:000414095500009
ISSN
1355-6037
DOI
10.1136/heartjnl-2016-310716
language
English
LU publication?
yes
id
c85b2e2d-c669-4a70-a942-18c4f4941af1
date added to LUP
2017-11-22 12:37:58
date last changed
2018-01-16 13:26:18
@article{c85b2e2d-c669-4a70-a942-18c4f4941af1,
  abstract     = {<p>Objective Low physical fitness and obesity have been associated with higher risk of developing heart failure (HF), but their interactive effects are unknown. Elucidation of interactions among these common modifiable factors may help facilitate more effective primary prevention. Methods We conducted a national cohort study to examine the interactive effects of aerobic fitness, muscular strength and body mass index (BMI) among 1 330 610 military conscripts in Sweden during 1969-1997 (97%-98% of all 18-year-old men) on risk of HF identified from inpatient and outpatient diagnoses through 2012 (maximum age 62 years). Results There were 11 711 men diagnosed with HF in 37.8 million person-years of follow-up. Low aerobic fitness, low muscular strength and obesity were independently associated with higher risk of HF, after adjusting for each other, socioeconomic factors, other chronic diseases and family history of HF. The combination of low aerobic fitness and low muscular strength (lowest vs highest tertiles) was associated with a 1.7-fold risk of HF (95% CI 1.6 to 1.9; p&lt;0.001; incidence rates per 100 000 person-years, 43.2 vs 10.8). These factors had positive additive and multiplicative interactions (p&lt;0.001) and were associated with increased risk of HF even among men with normal BMI. Conclusions Low aerobic fitness, low muscular strength and obesity at the age of 18 years were independently associated with higher risk of HF in adulthood, with interactive effects between aerobic fitness and muscular strength. These findings suggest that early-life interventions may help reduce the long-term risk of HF and should include both aerobic fitness and muscular strength, even among persons with normal BMI.</p>},
  author       = {Crump, Casey and Sundquist, Jan and Winkleby, Marilyn A. and Sundquist, Kristina},
  issn         = {1355-6037},
  keyword      = {body mass index,heart failure,muscle strength,obesity,physical fitness},
  language     = {eng},
  month        = {11},
  number       = {22},
  pages        = {1780--1787},
  publisher    = {BMJ Publishing Group},
  series       = {Heart},
  title        = {Aerobic fitness, muscular strength and obesity in relation to risk of heart failure},
  url          = {http://dx.doi.org/10.1136/heartjnl-2016-310716},
  volume       = {103},
  year         = {2017},
}