Impact of changes in physical activity or BMI on risk of heart failure in women – the prospective population study of women in Gothenburg

Figures & data

Table 1. Examinations and participation rates of women born in 1908, 1914, 1918, 1922 and 1930 examined in 1968, 1980 and 1992, and women born in 1942 and 1954 examined in 1980 and 1992.

Year of birth	1968 examination			1980 examination			1992 examination
	Age	n	%	Age	n	%	Age	n	%
1954	–	–	–	26	85	66^a	38	69	72^b
1942	–	–	–	38	122	85^a	50	99	76^b
1930	38	372	91^c	50	355	83^d	62	275	67^d
1922	46	431	90	58	332	77^d	70	303	63^d
1918	50	398	91^c	62	325	82^d	74	213	54^d
1914	54	180	89^c	66	140	78^d	78	79	44^d
1908	60	81	84^c	72	49	60^d	84	19	23^d
Total	38–60	1462	90^c	26–72	1408	79^e	38–84	1057	57^e

^a Of those sampled in 1980–1981.

^b Of those participating in 1980–1981.

^c Of those initially invited.

^d Of the original women in each age group who participated in the examination 1968–1969.

^e Of the women born in 1908–1930 who participated in 1968–1969.

Figure 1. Kaplan–Meier survival plots for HF and change in BMI, level of physical activity and change in physical activity 1968–1980 and 1980–1992. (a,b) Change in BMI, 1968–1980 and 1980–1992. (c,d) Level of physical activity and change in physical activity 1968–1980 and 1980–1992.

Table 2. Incidence and risk time analysis of incidence of HF 1968–2012 and 1980–2012.

Period	N	Cases	Risk years	Risk per 1000 years	95% CI Risk per 1000 years	Mean age in risk time	Age range
1968–2012	1132	271	26,111	10.4	9.2–11.7	71.2	50.3–98.8
1980–2012	773	174	11,254	15.5	13.2–17.9	77.4	62.4–98.8

Women born in 1942 and 1954 were excluded.

Table 3. Baseline characteristics for women participating in examinations 1968, 1980 and 1992.

	1968			1980			1992
	BMI			BMI			BMI
	<25, N = 817, m^a, (SD)	25–<30, N = 310, m^a, (SD)	>30, N = 82, m^a, (SD)	<25, N = 826, m^a, (SD)	25–<30, N = 445, m^a, (SD)	>30, N = 135, m^a, (SD)	<25, N = 483, m^a, (SD)	25–<30, N = 366, m^a, (SD)	>30, N = 180, m^a, (SD)
Age (years)	46 (6)	48 (6)	49 (6)	53 (12)	58 (8)	58 (9)	64 (12)	66 (10)	68 (8)
SBP (mmHg)	129 (19)	136 (20)	148 (27)	136 (24)	146 (23)	151 (24)	145 (27)	153 (23)	160 (23)
DBP (mmHg)	83 (10)	87 (10)	94 (13)	86 (11)	90 (10)	94 (9)	79 (11)	84 (11)	87 (10)
B-Glucose (mmol/l)	4.1 (0.7)	4.2 (0.8)	4.5 (0.8)	4.1 (1.1)	4.4 (1.1)	4.9 (1.7)	4.4 (1.0)	4.7 (1.4)	5.1 (1.2)
Cholesterol (mmol/l)	6.8 (1.3)	6.9 (1.0)	7.3 (1.2)	6.8 (1.3)	7.0 (1.4)	6.8 (1.3)	6.1 (1.2)	6.3 (1.1)	6.3 (1.1)
Triglycerides (mmol/l)	1.1 (0.6)	1.3 (0.5)	1.5 (0.6)	1.2 (0.6)	1.5 (0.8)	1.6 (0.7)	1.2 (0.6)	1.5 (0.8)	1.8 (0.8)
	(%)	(%)	(%)	(%)	(%)	(%)	(%)	(%)	(%)
Physical Activity: Non-active	16	21	21	27	29	42	18	21	28
Smokers^b	44	33	24	39	28	22	24	20	14
Alcohol^c	56	47	35	45	32	29	52	51	38

^a Mean value.

^b Women who smoked or had stopped smoking during the previous year.

^c More than once a month.

Table 4. Distribution of BMI categories, change in BMI, physical activity levels, change in physical activity levels and cases of HF for women participating in the examinations 1968–1980 and 1980–1992.

BMI	1968–1980, n = 1132		1980–1992, n = 932
	1968	1980	1980	1992
BMI <25, n (%)	769 (67.9)	611 (54.0)	571 (61.3)	446 (47.9)
≤25 BMI <30, n (%)	289^a (25.5)	404^b (35.7)	287^b (30.8)	327^c (35.1)
BMI ≥30, n (%)	74^d (6.5)	117^b (10.3)	74^b (7.9)	159^e (17.1)
BMI change	1968–1980, n = 1132		1980–1992, n = 932
BMI increase from ≤25 BMI <30 to BMI ≥30, n (%)	59 (5.2)		87 (9.3)
BMI decrease from BMI ≥30 to ≤25 BMI <30, n (%)	18 (1.6)		12 (1.3)
No change; ≤25 BMI <30	197 (17.4)		168 (18.0)
No change; BMI ≥30, n (%)	54 (4.8)		60 (6.4)
Cases of HF, n (%)	271 (23.9)		187 (20.1)
Physical activity	1968–1980, n = 1132		1980–1992, n = 932
	1968	1980	1980	1992
Non-active, n (%)	194 (17.1)	328 (29.0)	255 (27.4)	199 (21.4)
Active, n (%)	938 (82.9)	804 (71.0)	677 (72.6)	733 (78.6)
Physical activity change	1968–1980, n = 1132		1980–1992, n = 932
Activity increase from non-active to active, n (%)	92 (8.1)		171 (18.3)
Activity decrease from active to non-active n (%)	226 (20.0)		115 (12.3)
No change; active, n (%)	712 (62.9)		562 (60.3)
Cases of HF, n (%)	271 (23.9)		187 (20.1)

^a Mean age 48 years.

^b Mean age 58 years.

^c Mean age 66 years.

^d Mean age 49 years.

^e Mean age 68 years.

Table 5. Hazard ratios for HF and change in physical activity and BMI, adjusted for age.

	HR	p Value	95 % CI
Change in BMI between 1968 and 1980
Increase in BMI from normal to overweight	1.26	0.17	0.90–1.76
Increase in BMI from overweight to obese	1.93	0.008	1.18–3.14
Decrease in BMI from obese to overweight	0.49	0.32	0.12–2.00
Decrease in BMI from overweight to non-overweight	1.30	0.45	0.66–2.59
No change; obese both in 1968 and in 1980	1.21	0.46	0.73–1.99
No change; overweight both in 1968 and in 1980	1.26	0.18	0.90–1.72
BMI <25 in 1968 and 1980 (reference group)	1.00
Change in BMI between 1980 and 1992
Increase in BMI from normal to overweight	1.07	0.78	0.67–1.70
Increase in BMI from overweight to obese	1.10	0.71	0.66–1.85
Decrease in BMI from obese to overweight	1.47	0.59	0.36–6.07
Decrease in BMI from overweight to non-overweight	1.62	0.20	0.77–3.42
No change; obese both in 1980 and in 1992	1.27	0.41	0.72–2.21
No change; overweight both in 1980 and in 1992	1.01	0.96	0.66–1.54
BMI <25 in 1980 and 1992 (reference group)	1.00
Change in physical activity between 1968 and 1980
Increase from non-active to active	0.71	0.26	0.40–1.28
Decrease from active to non-active	0.71	0.15	0.44–1.13
No change; active both in 1968 and in 1980	0.66	0.04	0.44–0.99
Non-active in 1968 and 1980 (reference group)	1.00
Change in physical activity between 1980 and 1992
Increase from non-active to active	0.40	0.002	0.22–0.72
Decrease from active to non-active	0.73	0.28	0.41–1.29
No change; active both in 1980 and in 1992	0.47	0.001	0.29–0.74
Non-active in 1980 and 1992 (reference group)	1.00

Reference groups: BMI < 25, 1968–1980 and 1980–1992; non-active, 1968–1980 and 1980–1992.

Bold figures: statistically significant, level of significance p ≤ 0.05.