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Factors limiting habitual exercise in patients with chronic heart failure: a multicenter prospective cohort study

  • Soichiro Tadaki
  • Yasuhiko SakataEmail author
  • Yutaka Miura
  • Kotaro Nochioka
  • Masanobu Miura
  • Satoshi Miyata
  • Masanori Asakura
  • Kazunori Shimada
  • Takeshi Yamamoto
  • Yoshihiro Fukumoto
  • Toshiaki Kadokami
  • Satoshi Yasuda
  • Toshiro Miura
  • Shin-ichi Ando
  • Masafumi Yano
  • Masafumi Kitakaze
  • Hiroyuki Daida
  • Hiroaki Shimokawa
Original Article
  • 11 Downloads

Abstract

Physical activity (PA) in the daily life is strongly related to prognosis in patients with or at high risk of heart failure (HF). However, factors limiting habitual exercise and their prognostic impacts remain unknown in HF patients. We sent questionnaires asking factors limiting habitual exercise in the daily life to 8370 patients with Stage A/B/C/D HF in our nationwide registry and received valid responses from 4935 patients (mean age 71.8 years, 71.0% male). Among the 5 components consisting of “busyness”, “weak will”, “dislike, “socioeconomic reasons” and “diseases” in the questionnaires, “busyness” (34.5%) and “diseases” (34.7%) were the most frequently reported factors limiting habitual exercise, while “socioeconomic reasons” were the least (15.3%). Multiple Cox proportional hazard models indicated that “busyness”and “diseases” were associated with better (hazard ratio (HR) 0.53, 95% confidence interval (CI) 0.39–0.72, P < 0.001) and worse prognosis (HR 1.57, 95% CI 1.21–1.98, P < 0.001), respectively, while other components were not. Furthermore, it was noted that, while prognostic relevance of “busyness” limiting exercise did not differ by age or sex, negative impact of “diseases” was particularly evident in patients with age < 75 years (P for interaction < 0.01). Factors limiting habitual exercise were associated with “busyness” and “diseases”, but not with “weak will”, “dislike, or “socioeconomic reasons”. While “busyness” was associated with better prognosis regardless of age and sex, “diseases” was associated with worse prognosis in younger populations. Thus, physicians may pay more attentions to the reasons that limit exercise in the daily lives of HF patients rather than the low amount of exercise itself.

Keywords

Physical activity Exercise Chronic heart failure Prognosis Busyness Diseases 

Notes

Funding

This study was supported in part by the Grants-in Aid from the Ministry of Health, Labour, and Welfare (Grant Nos. 201412015B, 201120009B, 200825012B) and the Agency for Medical Research and Development (15ek0210043h0001), Tokyo, Japan.

Compliance with ethical standards

Conflict of interest

The Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine is supported in part by unrestricted research grants from Daiichi Sankyo Co., Ltd. (Tokyo, Japan), Bayer Yakuhin, Ltd. (Osaka, Japan), Kyowa Hakko Kirin Co., Ltd. (Tokyo, Japan), Kowa Pharmaceutical Co., Ltd. (Tokyo, Japan), Novartis Pharma K.K. (Tokyo, Japan), Dainippon Sumitomo Pharma, Co., Ltd. (Osaka, Japan), Nippon Boehringer Ingelheim Co., Ltd. (Tokyo, Japan), Astellas Pharma (Tokyo, Japan), AstraZeneca (Osaka, Japan), Chugai Pharmaceutical (Tokyo, Japan), GlaxoSmithKline (Tokyo, Japan), Mitsubishi Tanabe Pharma (Osaka, Japan), Mochida Pharmaceutical (Tokyo, Japan), MSD (Tokyo, Japan), Otsuka Pharmaceutical (Tokyo, Japan), Shionogi (Osaka, Japan) and Takeda Pharmaceutical (Tokyo, Japan). H.S. has received lecture fees from Bayer Yakuhin, Ltd. (Osaka, Japan), Daiichi Sankyo Co., Ltd. (Tokyo, Japan) and Novartis Pharma K.K. (Tokyo, Japan).

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Soichiro Tadaki
    • 1
  • Yasuhiko Sakata
    • 1
    • 2
    Email author
  • Yutaka Miura
    • 1
  • Kotaro Nochioka
    • 1
    • 2
  • Masanobu Miura
    • 1
  • Satoshi Miyata
    • 1
    • 3
  • Masanori Asakura
    • 4
    • 5
  • Kazunori Shimada
    • 6
  • Takeshi Yamamoto
    • 7
  • Yoshihiro Fukumoto
    • 8
  • Toshiaki Kadokami
    • 9
  • Satoshi Yasuda
    • 5
  • Toshiro Miura
    • 10
  • Shin-ichi Ando
    • 9
  • Masafumi Yano
    • 7
  • Masafumi Kitakaze
    • 5
  • Hiroyuki Daida
    • 6
  • Hiroaki Shimokawa
    • 1
    • 2
    • 3
  1. 1.Department of Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
  2. 2.Big Data Medicine CenterTohoku UniversitySendaiJapan
  3. 3.Department of Evidence-based Cardiovascular MedicineTohoku University Graduate School of MedicineSendaiJapan
  4. 4.Caridiovascular Division, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
  5. 5.Cardiovascular Division of Internal MedicineNational Cerebral and Cardiovascular CenterSuitaJapan
  6. 6.Department of Cardiovascular MedicineJuntendo University School of MedicineTokyoJapan
  7. 7.Division of Cardiology, Department of Medicine and Clinical ScienceYamaguchi University Graduate School of MedicineUbeJapan
  8. 8.Department of Internal Medicine Division of Cardio-Vascular MedicineKurume University School of MedicineKurumeJapan
  9. 9.Division of Cardiovascular MedicineSaiseikai Futsukaichi HospitalChikushinoJapan
  10. 10.Division of Integrated General MedicineTokuyama Central HospitalShunanJapan

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