Release Date: 08/15/2016
Charles Eaton, MD, director of the Center for Primary Care and Prevention at Memorial Hospital, a Care New England Hospital, recently received a $2.6-million grant from the National Heart, Lung and Blood Institute to launch the first and largest community-based primary prevention trial on the effects exercise and strength training have on heart failure in elderly women.
The five-year Women’s Health Initiative Strong and Healthy (WHISH)-2 Prevent Heart Failure Study - an extension of the Women’s Health Initiative that has continued for the past two decades across the country, including a site at Memorial – will examine the effects of physical activity both on the prevention of heart failure and the burden of the disease in women who were previously diagnosed with it.
“Poor outcomes for the sub-type of heart failure called ‘heart failure with preserved ejection fraction’ or ‘diastolic heart failure’ in the elderly have changed little in the past two decades, despite advances in therapy for the other type of heart failure associated with reduced ejection fraction,” Dr. Eaton explains.
The incidence of heart failure, he continues, is more common in women than in men, and affects people as they age, when they typically exercise less and lose muscle strength and physiologic reserve.
“We believe that improving exercise capacity and muscle strength could attenuate and even reverse heart failure as the person ages,” Dr. Eaton says. “Previous observational research has shown that even modest levels of physical activity can help, in comparison to a sedentary lifestyle.”
There have, however, been no research trials to date that probe whether changing levels of physical activity is effective in reducing one’s risk of heart failure, especially in older adults. In addition, the amount of physical activity needed for such protection is unclear. The WHISH-2 Prevent Heart Failure study will address the following aims:
• Test whether older women who do not initially have heart failure avoid it by beginning a physical activity regimen compared with women who do not exercise.
• Test whether older women with or without heart failure at the beginning of the trial see a reduction in the burden of the disease, in the form of hospitalizations and death, by engaging in physical activity compared with women who do not exercise.
In addition, Dr. Eaton says the study will analyze the type, intensity and frequency of physical activity, including skeletal muscle strengthening, to see if there’s a related reduction in the risk of heart failure and heart failure burden in the study participants.
“We believe we will find that women who increase or maintain light or moderate intensity physical activity will experience reduced rates of heart failure,” he says. “Those who add skeletal muscle strengthening will see additional health benefits.”
All study participants have already been recruited and randomized to receive the physical activity intervention or not.
Memorial Hospital of Rhode Island, a Care New England hospital, serves as the major teaching affiliate of The Warren Alpert Medical School of Brown University and the chief site for the medical school's primary care academic program. Research focuses on primary care and disease prevention, including osteoarthritis, heart disease, cancer, pulmonary function, maternal and child health and women’s health issues.
Memorial provides health services for the people of Rhode Island and southeastern Massachusetts including oncology, cardiovascular, orthopedics, rehabilitation, pain management, and diagnostics. Memorial offers primary care services in Pawtucket, Central Falls and Plainville, Massachusetts.