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Original research
Self-reported and objectively measured physical activity in people with and without chronic heart failure: UK Biobank analysis
  1. Johanna O'Donnell1,2,
  2. Karl Smith-Byrne3,
  3. Carmelo Velardo2,
  4. Nathalie Conrad1,
  5. Gholamreza Salimi-Khorshidi1,
  6. Aiden Doherty3,
  7. Terence Dwyer1,
  8. Lionel Tarassenko2 and
  9. Kazem Rahimi1
  1. 1George Institute for Global Health, University of Oxford, Oxford, Oxfordshire, UK
  2. 2Institute of Biomedical Engineering, University of Oxford, Oxford, UK
  3. 3Nuffield Department of Population Health, University of Oxford, Oxford, UK
  1. Correspondence to Dr Johanna O'Donnell; johanna.em.odonnell{at}


Objective The impact of heart failure (HF) on perceived and objectively measured levels of physical activity (PA) can inform risk stratification and treatment recommendation. We aimed to compare self-reported and objectively measured PA levels in a large sample of participants with and without HF.

Methods A validated PA questionnaire was used to estimate self-reported weekly PA among 1600 participants with HF and 387 580 participants without HF. Accelerometer data were studied in 596 participants with HF and 96 105 participants without HF for a period of 7 days. Using multivariable linear regression models, we compared the PA levels between participants with HF and without HF, focusing on both the average daily PA levels and the intensity of PAs throughout the day.

Results PA levels were significantly lower in participants with HF using both self-report (excess metabolic equivalent of task hours per week of 26.5 (95% CI 24.7 to 28.4) vs 34.7 (95% CI 34.5 to 34.9), respectively (p<0.001)) and accelerometer measures (mean accelerations of 23.7 milligravity (95% CI 23.1 to 24.4) vs 28.1 milligravity (95% CI 28.0 to 28.1), respectively (p<0.001)). Findings were consistent across different PA intensities. Hour-by-hour comparisons showed that accelerometer-derived PA levels of patients with HF were reduced throughout the day.

Conclusion Perceived and objectively recorded PA levels of patients with chronic HF are significantly lower than those of individuals without HF. This difference is continuous throughout the different hours of the day, with individuals with HF being on average 16% less active than individuals without HF. In patients with HF, increases in everyday activity may be a potential alternative to structured exercise programmes.

  • heart failure
  • epidemiology
  • heart failure treatment
  • public health

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  • Contributors JOD, KR and LT designed the project. JOD and KS-B performed the analysis of the data. CV, NC, GS-K and AD provided support on the analysis of the data. KR and TD provided support on the interpretation of the data. JOD wrote the paper with input from all authors.

  • Funding This work was supported by the National Institute of Health Research, Oxford Biomedical Research Centre (AD and KR) and the Oxford Martin School (KR and GS-K). JOD acknowledges the support of the RCUK Digital Economy Programme (grant number EP/G036861) (Oxford Center for Doctoral Training in Healthcare Innovation, UK). AD is also supported by the British Heart Foundation Centre of Research Excellence at Oxford, UK (grant number RE/13/1/30181).

  • Disclaimer No funding bodies had any role in the analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was covered by the general ethics approval for UK Biobank studies from the NHS National Research Ethics Service (ref 11/NW/0382).

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. Data cannot be shared publicly and is subject to a license agreement. Researchers who wish to obtain access to data should contact the UK Biobank Resource (

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