Device-Measured Physical Activity and Possible Association with Heart Failure

Apple watch, BPM
Apple watch, BPM
A study was conducted to evaluate the dose-response relationship between device-measured physical activity and heart failure outcomes.

Reduced risk for heart failure (HF) is associated with device-measured physical activity, especially moderate-intensity physical activity, according to study findings published in Circulation.

Researchers sought to evaluate the dose-response relationship between device-measured physical activity and HF stratified by physical activity intensity.

They conducted a prospective cohort study that included 94,739 UK Biobank participants between 2013 and 2015 with device-measured physical activity, and who, at baseline, had no history of HF and myocardial infarction. Time spent on light-, moderate-, and vigorous-intensity physical activity was measured with a wrist-worn accelerometer. Hospital and death records were reviewed for HF occurrence. The researchers evaluated adjusted sociodemographic and lifestyle associations using Cox proportional hazard models and competing risk with cause-specific hazard ratios (HRs).

The researchers found that the overall HF incidence (median follow-up, 6.1 years) was 98.5 per 10,000 person-years. There was a lower risk of HF among participants with 150 to 300 minutes/week of moderate-intensity physical activity (HR, 0.37; 95% CI, 0.34-0.41) and 75 to 150 min/wk of vigorous-intensity physical activity (HR, 0.34; 95% CI, 0.25-0.46) vs participants with no moderate- or vigorous-intensity physical activity. They noted a reverse-J shaped association between vigorous-intensity physical activity and HF with a possible lower risk reduction above 150 min/wk.

Study limitations include that the UK Biobank is not representative of the UK population and includes a possible healthy volunteer selection bias. There is residual confounding, reverse causation, the lack of differentiation in wrist accelerometers between light-physical activity and sedentary behavior. The study also lacks the ability to distinguish between HF with preserved ejection fraction vs HF without.

“Device-measured PA [physical activity], especially MPA [moderate-intensity physical activity], was associated with a lower risk of HF,” the study authors wrote. “The associations of VPA [vigorous-intensity physical activity] should be carefully examined before promotion of very high levels of VPA in the general population is considered.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Ho FK, Zhou Z, Petermann-Rocha F, et al. Association between device-measured physical activity and incident heart failure: a prospective cohort study of 94 739 UK Biobank participants. Circulation. Published online August 29, 2022. doi:10.1161/CIRCULATIONAHA.122.059663