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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.