Women’s Hearts: How Women Can Walk Away From Heart Failure !

Hello. This is Dr JoAnn Manson, professor of medicine at Harvard Medical School and Brigham and Women’s Hospital in Boston, Massachusetts. I’d like to talk with you about a study^[1] that was reported at the recent American College of Cardiology conference on the potential role of physical activity—specifically walking—in reducing risk for hospitalized heart failure in women. The study examined the role of walking frequency and the duration of walking episodes, as well as walking pace. It was conducted in the large-scale Women’s Health Initiative among more than 89,000 postmenopausal women, with an average follow-up of 10 years, during which time about 1100 women had a first hospitalization for heart failure. I’d like to acknowledge that I’m coauthor of this study.

We excluded at baseline women who had a history of heart failure, coronary heart disease, or cancer or who were unable to walk at least one block, and we adjusted for educational level, family income, body mass index, and smoking, and risk factors such as prior hypertension, diabetes, and high cholesterol.

We found a stepwise reduction in the risk for heart failure with increasing walking frequency, duration of walking episodes, and faster walking pace. We found that walking at least two to three times per week was associated with a significant reduction in risk, but it was best to walk daily. Also, we found that the duration of the episode was best if it was at least 40 minutes in length. For walking pace, we found a significant reduction with both average and brisk pace, but with a brisk pace, the risk reduction was 38%. Overall, the risk reduction was for heart failure with reduced ejection fraction, but there was also a signal for preserved ejection fraction heart failure.This is great news for women because walking is the most popular exercise among mid-life and older women, and it’s been linked to many other health benefits, including a lower risk for cognitive decline, coronary heart disease, stroke, osteoporotic fracture, diabetes, depression, and improved emotional well-being. So I think we can add a reduction in heart failure to an expansive list of health benefits of physical activity and regular walking. It seems that walking is as close to a magic bullet as we’ve come to good health, and we have one more reason for encouraging our patients to have regular physical activity, including regular walking.