Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults: The Health ABC Study

Vasiliki V. Georgiopoulou, Andreas P. Kalogeropoulos, Ritam Chowdhury, José Nilo G Binongo, Kirsten Bibbins-Domingo, Nicolas Rodondi, Eleanor Marie Simonsick, Tamara Harris, Anne B. Newman, Stephen B. Kritchevsky, Javed Butler

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Abstract

Introduction: Data on the association between exercise capacity and risk for heart failure (HF) in older adults are limited. Methods: This study examined the association of exercise capacity, and its change over time, with 10-year mortality and incident HF in 2,935 participants of the Health, Aging, and Body Composition Study without HF at baseline (age, 73.6 [SD=2.9] years; 52.1% women; 41.4% black; 58.6% white). This cohort was initiated in 1997-1998 and exercise capacity was evaluated with a long-distance corridor walk test (LDCW) at baseline and Year 4. Outcomes were collected in 2007-2008 and initial analysis performed in 2014. Results: Ten-year incident HF for completers (n=2,245); non-completers (n=331); and those excluded from LDCW for safety reasons (n=359) was 11.4%, 19.2%, and 23.0%, respectively. The corresponding 10-year mortality was 27.9%, 41.1%, and 42.4%. In models accounting for competing mortality, the adjusted subhazard ratio for HF was 1.37 (95% CI=1.00, 1.88;. p=0.049) in non-completers and 1.41 (95% CI=1.06, 1.89;. p=0.020) in those excluded versus completers. Non-completers (adjusted hazard ratio, 1.49; 95% CI=1.21, 1.84;. p<0.001) and those excluded (hazard ratio, 1.27; 95% CI=1.04, 1.55;. p=0.016) had elevated mortality. In adjusted models, LDCW performance variables were associated mainly with mortality. Only 20-meter walking speed and resting heart rate retained prognostic value for HF. Longitudinal changes in LDCW did not predict subsequent incident HF or mortality. Conclusions: Completing an LDCW is strongly associated with lower 10-year mortality and HF risk in older adults. Therefore, walking capacity may serve as an early risk marker.

Original languageEnglish (US)
JournalAmerican Journal of Preventive Medicine
DOIs
StateAccepted/In press - 2016
Externally publishedYes

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ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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Georgiopoulou, V. V., Kalogeropoulos, A. P., Chowdhury, R., Binongo, J. N. G., Bibbins-Domingo, K., Rodondi, N., Simonsick, E. M., Harris, T., Newman, A. B., Kritchevsky, S. B., & Butler, J. (Accepted/In press). Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults: The Health ABC Study. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2016.08.041