Physical Activity's Role in Waist Circumference and Heart Failure Risk

Introduction

Heart failure (HF) affects approximately 6.2 million adults in the United States, presenting a major public health concern. Waist circumference (WC) is a well-established risk factor for HF, while moderate-to-vigorous physical activity (MVPA) has been suggested as a potential protective factor. This study investigates the relationship between WC and the incidence of heart failure hospitalization (HFH) and assesses whether MVPA modifies this association using data from the Jackson Heart Study (JHS).

Methods

Our preliminary analysis used JHS data to examine the association of WC (continuous, cm) and incidence of HFH. Self- reported MVPA was categorized as poor (0 minutes/week), intermediate (1-149 minutes/week), and ideal (150 minutes/week).

Descriptive statistics were used for demographic characteristics and distributions of WC, MVPA, and covariates (e.g. sedentary behavior, diabetes). Cox proportional hazards models were used to examine the association between WC and the incidence of HFH and whether this association was moderated by MVPA.

Results

Among 3,397 participants (median follow-up: 12.0 years), 280 HFH events occurred. The median WC was 103 cm (IQR: 96– 111 cm) for men and 98 cm (IQR: 89–106 cm) for women. Higher WC was associated with increased HFH risk (hazard ratio [HR] per cm = 1.013, 95% CI: 1.005, 1.023). MVPA was not independently associated with HFH after adjustment for covariates. Interaction terms for intermediate (HR = 1.01, 95% CI: 0.99, 1.03) and ideal MVPA levels (HR = 1.01, 95% CI: 0.99, 1.04) with WC suggest no effect modification.

Conclusions

Increased WC is linked to a greater risk of HFH, independent of MVPA levels. These findings suggest that physical activity alone may not be sufficient to lower HF risk, particularly for individuals with abdominal obesity. Further research will incorporate restricted cubic splines and time-varying covariates to gain deeper insights into these associations.