Association between physical activity and long-term prognosis in older patients with Stage B heart failure

Physical activity is an important modifiable lifestyle factor associated with cardiovascular outcomes. However, its clinical significance in patients with Stage B heart failure (HF) remains unclear. This study investigated the association between physical activity and long-term outcomes and physical function in older patients with Stage B HF.

This sub-analysis of the multicenter PAPRIKA-HF registry assessed physical activity using the International Physical Activity Questionnaire (IPAQ) and categorized patients into high and low physical activity groups based on their median IPAQ score. The primary outcome was a composite of all-cause death, myocardial infarction hospitalization, and HF hospitalization during 2-year follow-up.

Older outpatients with Stage B HF (N, 308; median age, 78 years; 45% women) were included. The median physical activity level was 693MET-min/week, and 68 patients (22%) reported no physical activity. Patients with low physical activity levels had a significantly higher composite endpoint incidence than those with high physical activity levels (10.0% [16/160 patients] vs. 2.7% [4/148 patients], log-rank test; p = 0.008). On multivariable Cox regression adjusted for AHEAD score, low physical activity was independently associated with an increased risk of the composite endpoint (hazard ratio, 3.70; 95% confidence interval, 1.23-11.09; p = 0.01). Patients with low physical activity had significantly lower skeletal muscle mass, handgrip strength, and gait speed.

Lower physical activity was independently associated with adverse cardiovascular outcomes and impaired physical function in older patients with Stage B HF. Thus, physical activity may identify high-risk individuals before symptomatic HF develops.