Diastolic dysfunction is associated with sedentary leisure time physical activity and smoking in females only

Abstract

Objectives. Left ventricular diastolic dysfunction with preserved systolic function (DD-PSF) is associated with an increased risk of morbidity and mortality. Population-based surveys studying the associations between DD-PSF and lifestyle-associated risk factors, such as leisure time physical activity (LTPA) and smoking, are scarce. Thus, the aims were to explore the associations between DD-PSF and LTPA and smoking, employing optimal echocardiographic techniques. Design. Cross-sectional study conducted from 2001 to 2003. Setting.The study was conducted in a random sample of a rural Swedish population. Subjects. Men and women of 30–75 years of age were consecutively invited for conventional echocardiography and tissue velocity imaging (n = 1149). Structured questionnaires and physical examinations were conducted using standardized methods. Main outcome measures. DD-PSF was defined according to the European Society of Cardiology criteria excluding subjects with ejection fraction < 45%, or a self-reported history of heart failure. Results. Complete information was available in 500 men and 538 women. In a multivariate model, DD-PSF was independently associated with sedentary LTPA and smoking in females; sedentary LTPA odds ratio (OR) 2.91, 95% confidence interval (CI) 1.02 to 8.27, and smoking OR 3.42, 95% CI 1.35 to 8.64. The probability of identifying DD-PSF in females with a sedentary LTPA was 37% and increased to 80% if they also had hypertension and were obese. Conclusions. Sedentary LTPA and smoking are independently associated with DD-PSF in females. Identification of a sedentary lifestyle in females increases the probability of diagnosing DD-PSF.

Key Words::

• Echocardiography
• gender
• family practice
• leisure time physical activity
• smoking

Acknowledgements

The authors are indebted to Marianne Persson, Susanne Andersson, Maria Nyholm, and Ann Charlotte Agardh for excellent work in data collection.

Ethical approval

The investigation conforms to the principles outlined in the Declaration of Helsinki. The research ethics committee at the University of Gothenburg approved the study. The participants provided written informed consent for their participation in the health survey, and further written informed consent was obtained before undergoing an ultrasound-Doppler examination of the heart.

Funding sources

This work was supported by the Swedish Science Council; University of Gothenburg; Skaraborg Institute; Region Västra Götaland; Skaraborg Primary Care; Skåne Region; Lund University; University Hospital of Malmö donation Foundation; Påhlsson Foundation; Craaford Foundation; Lundberg Foundation. The funding source had no involvement in the work on this article.

Conflict of interests

The authors declare that they have no conflict of interests.