A new study reported in the Journal of the American Geriatric Society has linked faster walking speed to reduced risk of new onset heart failure (HF).

The associations of self-reported walking pace were examined with risk of incident HF and HF subtypes of preserved (HFpEF; EF ≥ 45%) and reduced (HFrEF; EF < 45%) ejection fractions in this prospective study.

The study population comprised of 25,183 postmenopausal women with ages ranging from 50 years to 79 years. These women were participants in the Womens Health Initiative (WHI) cohort between 1993 and 1998 and did not have heart failure or cancer at the time of study entry. Walking pace was categorized as casual <2 miles per hour, average 2-3 mph, and fast >3 mph. Information about physical activity (frequency of walks, duration of each walk and walking pace), smoking, diet and other behavioral factors was gathered in the form of questionnaires. Anthropometric measurements along with BP, history of diabetes, high cholesterol, family history of MI, use of HRT were documented.

After a follow up of nearly 17 years, 1455 new cases of acute decompensated HF, necessitating hospitalization, were recorded. The majority of them were HFpEF (n = 811), followed by HFrEF (n = 429) and those with unknown EF (n=215). A strong inverse relationship was noted between walking pace and the overall risk of HF with a hazard ratio of 0.73 for average vs casual walking and HR of 0.66 for fast vs casual walking.

When each subtype of HF was examined, a similar association was observed. The HR of association of walking pace with HFpEF was 0.73 for average vs casual walking pace and 0.63 for fast vs casual. For HFrEF, the HR was 0.72 for average vs casual and 0.74 for fast vs casual walking pace.

Compared with women who walked at a casual pace, those who walked at an average or fast pace had a 27% and 34% lower risk of HF, respectively. The risk of incident HF among those who walked fast for less than one hour per week was comparable or lower than the risk among those who walked at a casual or average pace for a duration of 1–2 hours and more than 2 hours walking in a week.

Brisk walking is the best form of exercise and is also the most common type of exercise undertaken. It does not require any special training or investment and its beneficial effects on health have been well-established. It is important to be physically active and engage in exercise, even if it is for only an hour in a day.

This study has demonstrated an inverse association of walking pace with the risk of HF, HFpEF, and HFrEF in postmenopausal women. The risk was lower for women who walked at a fast pace compared to those who walked with an average speed. Walking fast for shorter duration may be equivalent to or even better than walking for a longer duration but at a slower pace.

Hence, patients who walk at a slow pace should be evaluated for their risk of HF and counselled to be more active. Walking at an average pace was also found to be beneficial in this study. While the number of steps taken in a day is important, the speed at which these steps are taken is equally or perhaps more important.

Reference

1. Moafi-Madani Miremad, et al. The association of walking pace and incident heart failure and subtypes among postmenopausal women. J Am Geriatr Soc. 2022 Jan 20. doi: 10.1111/jgs.17657.