Heart failure is a major health concern, especially for ageing populations—it significantly increases mortality rates, and severely impacts quality of life for those affected. Exercise therapy has been shown to be particularly effective for patients with heart failure. Previous research, however, has mainly examined the benefits of exercise after a diagnosis of heart failure. There is a considerable gap when it comes to our understanding of the role that exercise plays before a patient with heart failure is hospitalized.
Now, in a recent study published in the European Journal of Preventive Cardiology on 19 February 2025, researchers from Japan have explored the link between exercise habits before hospitalization and post-discharge outcomes in older patients with heart failure. The study was led by Dr. Taisuke Nakade, at the Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine. Other members of the research team include Dr. Yuya Matsue, Dr. Daichi Maeda, Dr. Nobuyuki Kagiyama, and Dr. Tohru Minamino from the Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine.
“We wanted to explore whether even a small but consistent amount of physical activity before hospitalization could be associated with better post-discharge health outcomes, making exercise more accessible and practical for a broader range of patients with heart failure,” states Dr. Nakade. To accomplish this, the team analyzed data from the FRAGILE-HF study, which was conducted at 15 hospitals across Japan, including 1,262 patients aged 65 years and older who were hospitalized for heart failure. In addition, they assessed the exercise habits of these patients before hospitalization.
Of the 1,262 patients included in this study, it was found that 675 (53.4%) patients reported regular exercise habits before hospitalization—this included moderate exercise lasting 30 minutes or vigorous activity lasting 20 minutes, performed at least once daily per week. Interestingly, the researchers found that those patients who reported regular exercise habits before hospitalization had a lower risk of death, compared to patients who did not exercise regularly. Additionally, it was found that patients who exercised regularly had greater grip strength and higher gait speeds (measured as the time taken to walk over a specified short distance). This indicated that regular exercise was also linked to better strength and physical function in older patients.
The findings of this study emphasize the importance of promoting regular exercise for older patients. They suggest that even a minimal level of physical activity (such as walking or moderate exercise once or twice a week) is linked to better outcomes in this population. Emphasizing the importance of these results for informing clinical practices, Dr. Nakade explains, “Although the nature of this study does not allow us to establish a causal relationship, our study supports more inclusive and feasible exercise recommendations for older patients. The findings of this study have led us to consider the effects of ‘muscle banking,’ which has potential benefits in preventing further health deterioration.”
Besides encouraging more inclusive clinical practices for older patients, the researchers of the study envision exciting opportunities for collaboration with the fitness and wearable technology industries. Wearable devices and digital health platforms could play a crucial role in supporting heart failure patients by offering real-time activity tracking, personalized exercise recommendations, and even the early detection of physical decline.
Given the growing burden of heart failure worldwide, the results of this study have highly relevant implications for healthcare policy, rehabilitation programs, and even patient education. Moreover, it highlights the importance of exercise in maintaining health and providing resilience against physical deterioration—we should all be aware of the importance of physical activity and consider it as an invaluable investment in our long-term health!
Reference
Authors
Taisuke Nakade1, Daichi Maeda1, Yuya Matsue1, Nobuyuki Kagiyama1,2, Yudai Fujimoto1, Tsutomu Sunayama1, Taishi Dotare1, Kentaro Jujo3, Kazuya Saito4, Kentaro Kamiya5, Hiroshi Saito6, Yuki Ogasahara7, Emi Maekawa8, Masaaki Konishi9, Takeshi Kitai10, Kentaro Iwata11, Hiroshi Wada12, Takatoshi Kasai1,13, Hirofumi Nagamatsu14, Shin-ichi Momomura15, Tohru Minamino1,16
Title of original paper
Association of pre-admission exercise habit with post-discharge outcomes for older patients with heart failure
Journal
European Journal of Preventive Cardiology
DOI
10.1093/eurjpc/zwaf069
Affiliations
1Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
2Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan
3Department of Cardiology, Nishiarai Heart Centre Hospital, Tokyo, Japan
4Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
5Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
6Department of Rehabilitation, Kameda Medical Centre, Kamogawa, Japan
7Department of Nursing, The Sakakibara Heart Institute of Okayama, Okayama, Japan
8Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
9Division of Cardiology, Yokohama City University Medical Centre, Yokohama, Japan
10Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
11Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe, Japan
12Department of Cardiovascular Medicine, Saitama Medical Centre, Jichi Medical University, Saitama, Japan
13Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
14Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
15Saitama Citizens Medical Centre, Saitama, Japan
16Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Tokyo, Japan
About Dr. Taisuke Nakade from Juntendo University
Dr. Taisuke Nakade is a Doctor of Medicine in the Department of Cardiovascular Biology and Medicine at the Juntendo University Graduate School of Medicine, Japan. His research encompasses a wide range of topics in cardiology, including heart failure and exercise-based cardiac rehabilitation, and he has published over 15 articles in this field. He is also a member of prestigious societies, such as the European Society of Cardiology (ESC) and the Heart Failure Association (HFA) of the ESC.
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