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

Research output: Contribution to journalArticle

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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Heart Failure
Exercise
Mortality
Health
Body Composition
Walking
Heart Rate
Walk Test
Safety

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Georgiopoulou, V. V., Kalogeropoulos, A. P., Chowdhury, R., Binongo, J. N. G., Bibbins-Domingo, K., Rodondi, N., ... 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

Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults : The Health ABC Study. / Georgiopoulou, Vasiliki V.; Kalogeropoulos, Andreas P.; Chowdhury, Ritam; Binongo, José Nilo G; Bibbins-Domingo, Kirsten; Rodondi, Nicolas; Simonsick, Eleanor Marie; Harris, Tamara; Newman, Anne B.; Kritchevsky, Stephen B.; Butler, Javed.

In: American Journal of Preventive Medicine, 2016.

Research output: Contribution to journalArticle

Georgiopoulou, VV, Kalogeropoulos, AP, Chowdhury, R, Binongo, JNG, Bibbins-Domingo, K, Rodondi, N, Simonsick, EM, Harris, T, Newman, AB, Kritchevsky, SB & Butler, J 2016, '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
Georgiopoulou, Vasiliki V. ; Kalogeropoulos, Andreas P. ; Chowdhury, Ritam ; Binongo, José Nilo G ; Bibbins-Domingo, Kirsten ; Rodondi, Nicolas ; Simonsick, Eleanor Marie ; Harris, Tamara ; Newman, Anne B. ; Kritchevsky, Stephen B. ; Butler, Javed. / Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults : The Health ABC Study. In: American Journal of Preventive Medicine. 2016.
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title = "Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults: The Health ABC Study",
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.",
author = "Georgiopoulou, {Vasiliki V.} and Kalogeropoulos, {Andreas P.} and Ritam Chowdhury and Binongo, {Jos{\'e} Nilo G} and Kirsten Bibbins-Domingo and Nicolas Rodondi and Simonsick, {Eleanor Marie} and Tamara Harris and Newman, {Anne B.} and Kritchevsky, {Stephen B.} and Javed Butler",
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T1 - Exercise Capacity, Heart Failure Risk, and Mortality in Older Adults

T2 - The Health ABC Study

AU - Georgiopoulou, Vasiliki V.

AU - Kalogeropoulos, Andreas P.

AU - Chowdhury, Ritam

AU - Binongo, José Nilo G

AU - Bibbins-Domingo, Kirsten

AU - Rodondi, Nicolas

AU - Simonsick, Eleanor Marie

AU - Harris, Tamara

AU - Newman, Anne B.

AU - Kritchevsky, Stephen B.

AU - Butler, Javed

PY - 2016

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N2 - 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.

AB - 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.

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