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Association of Fitness and Grip Strength With Heart Failure: Findings From the UK Biobank Population-Based Study
Anne Sillars1, Carlos A Celis-Morales1, Frederick K Ho2
1Institute of Cardiovascular and Medical Sciences, United Kingdom.
Insights
Higher cardiorespiratory fitness (CRF) and grip strength (GS) are linked to a reduced risk of heart failure (HF). These objective measures of physical function independently predict lower HF incidence.
Area of Science:
- Cardiology
- Preventive Medicine
- Exercise Physiology
Background:
- Heart failure (HF) presents a significant social and economic burden.
- Objective measures of physical function, such as cardiorespiratory fitness (CRF) and grip strength (GS), are increasingly recognized as important health indicators.
Purpose of the Study:
- To investigate the association between objectively measured CRF and GS and the incidence of HF.
- To determine if CRF and GS are independent predictors of HF risk.
Main Methods:
- Utilized UK Biobank data from a large cohort (over 374,000 participants for GS, over 57,000 for CRF).
- Employed Cox proportional hazard models to analyze associations between CRF, GS, and incident HF, adjusting for confounders.
Main Results:
- Higher CRF was associated with an 18% lower risk of HF per 1-metabolic equivalent increment.
- Higher GS was associated with a 19% lower risk of HF per 5-kg increment.
- Standardized analysis showed a 50% lower HF risk per 1-SD increase in CRF and a 35% lower risk per 1-SD increase in GS.
Conclusions:
- Objective measurements of CRF and GS are strongly and independently associated with a lower incidence of HF.
- These findings highlight the potential of physical function metrics in HF risk assessment.
- Further research is warranted to explore the causal relationship and potential interventions targeting CRF and muscle strength for HF prevention.
Objective:
To investigate the associations of objectively measured cardiorespiratory fitness (CRF) and grip strength (GS) with incident heart failure (HF), a clinical syndrome that results in substantial social and economic burden, using UK Biobank data.
Patients And Methods:
Of the 502,628 participants recruited into the UK Biobank between April 1, 2007, and December 31, 2010, a total of 374,493 were included in our GS analysis and 57,053 were included in CRF analysis. Associations between CRF and GS and incident HF were investigated using Cox proportional hazard models, with adjustment for known measured confounders.
Results:
During a mean of 4.1 (range, 2.4-7.1) years, 631 HF events occurred in those with GS data, and 66 HF events occurred in those with CRF data. Higher CRF was associated with 18% lower risk for HF (hazard ratio [HR], 0.82; 95% CI, 0.76-0.88) per 1-metabolic equivalent increment increase and GS was associated with 19% lower incidence of HF risk (HR, 0.81; 95% CI, 0.77-0.86) per 5-kg increment increase. When CRF and GS were standardized, the HR for CRF was 0.50 per 1-SD increment (95% CI, 0.38-0.65), and for GS was 0.65 per 1-SD increment (95% CI, 0.58-0.72).
Conclusion:
Our data indicate that objective measurements of physical function (GS and CRF) are strongly and independently associated with lower HF incidence. Future studies targeting improving CRF and muscle strength should include HF as an outcome to assess whether these results are causal.