For better heart health, take a step forward, two studies say

BUFFALO, NY – If you’re sitting down, the results of two major new studies conducted by University of Buffalo researchers are likely to get you moving.

Women who met the federal physical activity guideline of 30 minutes a day of moderate activity solely by walking had a significantly lower risk of developing hypertension, according to an article published in the November issue of the American Heart Association’s journal Hypertension.

The study also reports that women who did not achieve recommended walking levels but who walked 2 mph (one 30-minute mile) or faster still had a reduced risk of hypertension.

Another study of more than 80,000 postmenopausal women between the ages of 5 and 79, published today in Circulation: Heart Failure, reports that more time spent in sedentary behaviors while awake, such as sitting or lying on the couch, is associated with a risk higher than hospitalization for heart failure. .

Indeed, women who spent more than 9.5 hours per day sitting or lying down had a 42% higher risk of developing heart failure during the nine years following the first assessment of sedentary time through the Observational Study of the Health Initiative. women. This finding was evident even after taking into account physical activity levels and heart failure risk factors such as hypertension, diabetes, obesity and heart attack.

Taken together, the two documents send a powerful message: “Sit less, walk more for heart health,” says Michael LaMonte, PhD, associate researcher in epidemiology at UB’s School of Public Health and Health Professions. LaMonte was the first author of the Circulation: Heart Failure study published today and senior author of the Hypertension paper.

Both documents were based on data collected over time by participants in the Women’s Health Initiative.

“The WHI participants provided us with information on the importance of walking, regular activity and the avoidance of sedentary time in the prevention of both hypertension and heart failure,” said Jean Wactawksi-Wende, PhD, co-author of both studies and dean of the UB School of Public Health and Health Professions. “Walking and moving are simple activities that can be easily integrated into our daily life.”

The study in the journal Hypertension found that brisk walking – identified as a 30-minute mile – for 150 minutes or more per week is associated with a lower risk of hypertension in older women.

“Our work adds to the growing evidence that you don’t necessarily have to be a jogger or cyclist to get health benefits from exercise,” said Connor Miller, first author of the paper on hypertension, on which he worked. while obtaining his master’s degree in epidemiology from UB.

“Just taking regular walks can have a significant impact on important risk factors for cardiovascular disease, in this case blood pressure. This is especially important for older adults to appreciate because walking is an accessible activity for all ages, ”added Miller, who is now an epidemiologist at the Roswell Park Comprehensive Cancer Center.

Few studies have evaluated hypertension in relation to walking, a common physical activity among adults. Miller and his colleagues examined the association between walking and the incidence of hypertension in 83,435 postmenopausal women aged 50 to 79 who did not have hypertension, heart failure, coronary artery disease, or stroke and reported the ability to walk at least one block without assistance.

During an average of 11 years follow-up, they identified 38,230 cases of hypertension. After checking for sociodemographic, lifestyle and clinical factors, the researchers observed significantly lower hypertension risks of 11% and 21% in postmenopausal women who reported higher walking volume and speed.

Walking speed remained significantly associated with a lower risk of hypertension after adjusting walking duration, suggesting that walking faster might have greater benefits on blood pressure than volume or duration.

“To put it simply, do your steps and try to make them faster,” said Miller.

The researchers also note that women whose walking speed was less than 2 mph had a significantly higher 5% to 8% higher risk of hypertension than non-walkers. This slower walking speed, Miller points out, has been associated with an increase in cardiovascular disease in previous WHI studies.

If further studies confirm the group’s findings, it is possible that a randomized clinical trial could be established to evaluate walking for primary prevention of hypertension in adults, Miller said.

“When recommending ways for a patient to change lifestyle factors, doctors can use this research to point out that even a relatively minor behavioral change – in this case, taking regular walks – is a step in the right direction for health. cardiovascular, “according to Miller.

And for someone who thinks their blood pressure levels seem to indicate there’s nothing they can do, Miller has a message. “Our research says otherwise. Even among those women who initially had blood pressure levels close to the hypertension threshold, the volume and speed of walking were still associated with a lower risk of developing hypertension later. “

Kathleen Hovey, data / statistics manager in the Department of Epidemiology and Environmental Health at UB, was also a co-author of the paper.

Very few studies have looked at sedentary time and heart failure risk, and none have focused on older women in whom both sedentary behavior and heart failure are common, says LaMonte of the Circulation: Heart Failure study he led. It is the follow-up to a 2018 paper that was the first to show an association between increased physical activity and a reduced risk of heart failure.

During an average of nine years of follow-up, 1,402 women were hospitalized due to heart failure. Compared to women who reported spending less than 6.5 hours per day sitting or lying down, the risk of hospitalization for heart failure was:

• 15% more in women who report 6.6-9.5 hours per day spent sitting or lying down;
• 42% more in women who report more than 9.5 hours per day spent sitting or lying down.

Compared to women who reported sitting less than 4.5 hours per day, the risk of hospitalization for heart failure was:

• 14% more in women who sat between 4.6 and 8.5 hours a day;
• 54% more in women who sat more than 8.5 hours a day.

Researchers found a 42% higher risk of developing heart failure among women who were sedentary for more than 9.5 hours per day even after taking into account several factors, including age, ethnicity and use of hormone therapy in menopause. . When they further considered heart attack – a major cause of heart failure that also leads to more sedentary time – the significantly increased risk of heart failure continued to be seen with prolonged sitting time.

“Even among women who reported recreational physical activity levels that meet current guidelines, the risk of heart failure was high in women who also reported more than 9.5 hours per day of sedentary activity,” LaMonte said. “This latest finding indicates the need not only to promote greater physical activity for the prevention of heart failure, but also to promote the interruption of sedentary time during the day.”

The team will soon have the results of a separate WHI study using accelerometers, which will show that simply standing up to interrupt sedentary time is associated with a lower risk of cardiovascular disease.

Sedentary behavior promotes poorer cardiometabolic risk factor profiles, which increases the likelihood of the onset and progression of arterial atherosclerosis and blood clots in the arteries, LaMonte explains. These are the precursors of angina and heart attack, of which heart failure is one of the main consequences. Sedentary time also reduces the pumping effectiveness of the heart, which is a major manifestation of clinical heart failure.

“It is unclear whether sedentary time directly causes reduced cardiac pumping efficacy or exacerbates the effect of some other cause. An observational study like ours cannot untangle these complex mechanistic issues, ”LaMonte said.

Researchers from the Fred Hutchinson Cancer Research Center, Harvard University, University of California San Diego, University of Alabama at Birmingham, University of Arizona Cancer Center, University of Tennessee Health Sciences Center, University of California San Francisco, Brown University and Stanford University contributed to the paper.