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Background  Given high rates of obesity, hypertension, and diabetes mellitus, black persons are at risk to develop heart failure. The association of moderate to vigorous physical activity ( MVPA ) and heart failure in black adults is underresearched. The purpose of this study was to explore whether greater  MVPA  was associated with lower risk of heart failure hospitalizations (HFHs) among black adults with normal ejection fractions.    Methods and Results  We performed a prospective analysis of 4066 black adults who participated in the Jackson Heart Study and who had physical activity measured, had normal ejection fraction on 2‐dimensional echocardiograms, and were followed for 7 years for incident HFH. We used Cox proportional regression analyses adjusted for age, sex, body mass index, smoking status, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, coronary heart disease, atrial fibrillation, and chronic kidney disease and examined effect modification by sex and body mass index. Of the eligible population, 1925 participants, according to the duration of  MVPA , had poor health (0 minutes/week), 1332 had intermediate health (1–149 minutes/week), and 809 had ideal health (≥150 minutes/week). There were 168 incident  HFHs . MVPA for intermediate and ideal health was associated with decreasing risk of incident  HFH  (hazard ratio: 0.70 [95% confidence interval, 49–1.00] and 0.35 [95% confidence interval, 0.19–0.64], respectively;  P  trend =0.003). The full model revealed hazard ratios of 0.74 [95% confidence interval, 0.52–1.07] and 0.41 [95% confidence interval, 0.22–0.74], respectively. There was no effect modification between  MVPA  and body mass index or sex on incident  HFH .    Conclusions  A dose‐response relationship between increasing levels of  MVPA  and protection from incident  HFH  was found in black men and women with normal ejection fractions.

journal of the american heart association

Prospective Association of Physical Activity and Heart Failure Hospitalizations Among Black Adults With Normal Ejection Fraction: The Jackson Heart Study