Comprehensive analysis of factors determining low physical activity in patients with heart failure

Aim. To analyze the sociodemographic, clinical, and behavioral characteristics of patients with heart failure (HF) based on their selfassessed current level of total physical activity (TPA), as well as changes of TPA and awareness of its benefits over time.

Material and methods. This cross-sectional survey was conducted in 2018 and 2024 as part of "HF Awareness Days". The self-administered questionnaire included questions about social status, TPA level, and attitudes toward physical activity as a treatment method for HF. Physicians completed brief information about the phenotype and functional class of HF.

Results. In the second wave of the survey, the number of unemployed patients who characterized their TPA as low or extremely low increased as follows: 74% of women and 64% of men in 2018 and 82% of women and 70% of men in 2024. Patients with a low TPA were more likely to report hospitalizations in the last six months preceding the survey. No higher education increased the odds of low TPA by more than 2,5 times in women (odds ratio (OR) =2,62; 95% confidence interval (CI): 1,360-5,126; p=0,003) and more than 3,5 times in men (OR=3,59; 95% CI: 2,06-6,26; p<0,001). Living with a spouse or children did not show a significant association with the TPA level. In women with HF, preserved ejection fraction (HFpEF) increased the likelihood of low TPA (OR=2,83; 95% CI: 153-5,34; p<0,001), while in men, HFpEF decreased the likelihood of low TPA (OR=0,425; 95% CI: 0,239-0,757; p<0,001). In addition, 67% of patients indicated bothersome symptoms as the reason for decreased activity. Women with low TPA were 3 times less likely, while men were 2 times less likely to consider exercise a method of HF treatment (OR=3,05; 95% CI: 1,64-5,67; p<0,001) and (OR=2,181; 95% CI: 1,422-3,362; p<0,001). In 2024, more patients acknowledged the exercise benefits than in 2018 (OR=2,3; 95% CI: 1,5-3,5; p=0,001).

Conclusion. More than a third of women and more than half of men in both waves of the study reported low total physical activity (TPA). Those at highest risk for low TPA include women over 70 years of age, without a higher education and with HF. Patients who described their lifestyle as inactive were significantly more likely to be unaware of the benefits of exercise for HF.

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