Sedentary Behavior and Heart Failure Risk in Postmenopausal Women

Sedentary postmenopausal women are at high risk of heart failure hospitalization, suggests a study published in the journal Circulation: Heart Failure on November 24, 2020.

The 2018 US Physical Activity Guidelines recommended reducing sedentary behaviour (SB) for cardiovascular health. More time spent sitting or lying down was associated with a significantly increased risk of heart failure in older women. However, the role of sedentary behaviour in heart failure (HF) is unclear. For this purpose, researchers in America conducted a study to assess the association between SB and the risk of heart failure in menopausal women.

They evaluated 80,982 women in the Women's Health Initiative Observational Study, aged 50 to 79 years, who were without known HF and reported the ability to walk ≥1 block unassisted at baseline. Researchers assessed the SB repeatedly by questionnaire. The time spent sedentary (combined sitting or lying down) was divided into tertiles of 6.5 hours or less, 6.6-9.5 hours, and more than 9.5 hours. Time spent sitting was divided into tertiles of 4.5 hours or less; 4.6-8.5 hours; and more than 8.5 hours.

Key Findings of the Study

• Controlling for age, race/ethnicity, education, income, smoking, alcohol, menopausal hormone therapy, and hysterectomy status, researchers observed a higher HF risk across incremental tertiles of time-varying total SB with hazard ratios (HR) of about 1.00 for ≤6.5 hours of SB per day, 1.15 for 6.6-9.5 hours of SB per day, 1.42 for more than 9.5 hours per day.
• Similarly, for sitting time, they noted HR of about 1.00 [referent], 1.14 for 4.6-8.5 hours of SB per day, 1.54 for more than 8.5 hours of SB per day.
• They noted that the inverse trends also remained significant after further controlling for comorbidities including time-varying myocardial infarction and coronary revascularization (hazard ratios: SB, 1.00, 1.11, 1.27; sitting, 1.00, 1.09, 1.37) and for baseline physical activity (hazard ratios: SB 1.00, 1.10, 1.24; sitting 1.00, 1.08, 1.33).
• This suggests the hazard ratio for heart failure increases as study participants spent more time sitting down, and for women in the most active tertile, the HR was 1.00 versus 1.42 for women in the least active tertile.
• The trends remained significant after controlling for comorbidities including MI and coronary revascularization, and the associations were similar among categories of women with additional HF risk factors, including body mass index, diabetes, hypertension, and coronary heart disease.

The authors concluded, "SB was associated with increased risk of incident HF hospitalization in postmenopausal women. Targeted efforts to reduce SB could enhance HF prevention in later life."

"Our message is simple: sit less and move more," LaMonte further added in a statement.

For further information: Read the full study