Heart Failure Clinical Trial
Official title:
Women's Health Initiative Strong and Healthy Exercise Trial-2-Prevent Heart Failure
The WHISH-2-Prevent Heart Failure (HF) study is an ancillary study to the Women's Health Initiative Strong and Healthy (WHISH) exercise pragmatic trial. The WHISH-2-Prevent HF trial examines the intervention effect of physical activity (PA) on both incident HF and HF burden (recurrent HF and CVD death in those with HF) in a cost effective manner in elderly women. In addition, it will allow a dose-finding analysis to better understand the type, intensity and frequency of PA that leads to a reduced risk and burden of HF. The focus of the parent WHISH trial is on atherosclerotic cardiovascular disease and not heart failure.
A recently funded large pragmatic PA trial, Women's Health Initiative Strong and Healthy
(WHISH) trial based upon two decades of PA intervention experience using enhanced
communication and behavioral techniques, has randomized 49,936 elderly women (average age 79)
and will evaluate its intervention effect on the risk of atherosclerotic CVD. This
translational intervention is aimed at reducing sedentary time and achieving or maintaining
aerobic and strength enhancing PA levels currently recommended for cardiovascular benefit.
The WHISH-2-Prevent HF, represents the first and largest primary prevention exercise trial
ever performed focusing on HF and will examine the intervention effect of PA , on both
incident HF and HF burden (recurrent HF and CVD death in those with HF) in a cost effective
manner in elderly women. In addition, it will allow a dose-finding analysis to better
understand the type, intensity and frequency of PA that leads to a reduced risk and burden of
HF.
Aim 1: Test whether older women who are initially free of HF and randomized to a
translational PA intervention will reduce the rate of incident HF compared to those not
randomized to the translational PA intervention.
H1: Women free of HF randomized to the PA intervention will have reduced rates of incident HF
compared to those not randomized.
Aim 2: Test whether older women with and without HF at baseline randomized to a translational
PA intervention will reduce the HF burden (number of acute HF hospitalizations and CVD death
in those with antecedent HF) compared to those not randomized to the translational PA
intervention. H2: Women randomized to the PA intervention will have reduced HF Burden
compared to those not randomized
Exploratory Aim 3: Analyze the type, intensity and frequency of physical activity including
skeletal muscle strengthening associated with a reduced risk of HF and HF burden in elderly
women. H3: Women who have low levels of sedentary behavior by either increasing or
maintaining light intensity or moderate intensity physical activity will have reduced rates
of HF compared to women who remain sedentary. Those that add skeletal muscle strengthening
will have additional benefits.
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