Associations of Accelerometer-Determined Sedentary and Physical Activity Behaviors with Heart Failure Biomarkers during Midlife: CARDIA Study.

Abstract

Few studies have examined the longitudinal associations of accelerometer-based measures of sedentary and physical activity behaviors with subclinical heart failure (HF) in midlife. This is a key gap, given that an improved understanding of modifiable factors associated with HF risk may better inform prevention strategies. We hypothesize that more time in light intensity physical activity and/or moderate or vigorous intensity physical activity (MVPA) and less sedentary time will be related to lower levels of HF biomarkers (N-terminal pro B-type natriuretic peptide and high-sensitivity cardiac troponin T [hscTnT]) across midlife. Data are from 2494 Coronary Artery Risk Development in Young Adults (CARDIA) participants without clinical HF (58.9% women, 45.7% Black persons, mean [±standard deviation] aged 51.1 ± 7.2 yr at the baseline contributing exam) with at least one occurrence of concurrent valid accelerometer (ActiGraph 7164/GT3X; Ametris; Pensacola, FL) wear and HF biomarkers at the CARDIA year 20, 30 and/or year 35 follow-up examinations. Adjusted linear mixed effects models were used to estimate the associations. Heterogeneity in the associations by the four race-sex groups represented in CARDIA was also examined. In the fully adjusted models, every 5-min higher MVPA was associated with -0.05 (95% confidence interval: -0.09 to -0.01, P = 0.022) lower hscTnT. The associations of sedentary and light intensity physical activity with hscTnT and associations of any accelerometer estimate with N-terminal pro B-type natriuretic peptide were not statistically supported (all P > 0.05). Findings were similar when clinically relevant categories of HF biomarker outcomes were used in the analysis. Findings address research gaps in the literature and demonstrate the importance of MVPA during the midlife transition for HF prevention before the onset of overt signs or symptoms.