Havlik Richard J, Phillips Caroline L, Brock Dwight B, Lohman Kurt, Haskell William, Snell Peter, O'Toole Mary, Ribisl Paul, Vaitkevicius Peter, Spurgeon Harold A, Lakatta Edward G, Pullen Paul
Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, MD, USA.
Am Heart J. 2005 Aug;150(2):270-5. doi: 10.1016/j.ahj.2004.09.006.
The ACT was a clinical trial of various patient education and counseling interventions to increase physical activity in sedentary primary care populations. It provided the opportunity to measure the effect of increasing physical activity on aortic pulse wave velocity (APWV), a measure of vascular stiffness, in a relatively healthy middle-aged population. The effects of the interventions, as well as the impact of walking and correlates such as older age and maximal oxygen uptake (VO2max), on APWV were assessed.
The participants in this study were a subset of the 874 persons recruited for the ACT. Information about self-reported physical activity and disease status was collected at baseline (464 persons), 6-month (528 persons), and 24-month (555 persons) intervals. Physiological measures included APWV, systolic blood pressure, and other correlates.
In multivariate analyses, the various treatment arms did not have a significant effect on APWV. However, walking in hours per day was associated with slower APWV times or less stiffness (P = .03). This was significant for women and consistent but not significant for men. In addition, age, clinic site, race, systolic blood pressure, and VO2max were independently associated with APWV.
Increased walking frequency over a 24-month period was predictive of reduced vascular stiffness in ACT. The more significant result for walking frequency in women than in men might be caused by the presence of a low Vo2max or physical activity threshold for an effect of walking on APWV, which most women achieved but most men had surpassed at the start of the study. Although needing confirmation because this was a secondary analysis, modest physical activity may have a beneficial effect on large vessel structure.
“增加运动临床试验”(ACT)是一项针对各种患者教育和咨询干预措施的临床试验,旨在提高久坐不动的初级保健人群的身体活动水平。该试验提供了一个机会,来测量在相对健康的中年人群中增加身体活动对主动脉脉搏波速度(APWV,一种血管僵硬度的测量指标)的影响。评估了干预措施的效果,以及步行、年龄增长和最大摄氧量(VO2max)等相关因素对APWV的影响。
本研究的参与者是从ACT招募的874人中选取的一个子集。在基线(464人)、6个月(528人)和24个月(555人)时收集了关于自我报告的身体活动和疾病状况的信息。生理测量指标包括APWV、收缩压和其他相关指标。
在多变量分析中,各个治疗组对APWV没有显著影响。然而,每天步行的小时数与较慢的APWV时间或较小的僵硬度相关(P = 0.03)。这在女性中具有显著性,在男性中一致但不显著。此外,年龄、诊所地点、种族、收缩压和VO2max与APWV独立相关。
在ACT中,24个月内步行频率增加可预测血管僵硬度降低。女性步行频率的结果比男性更显著,可能是因为存在较低的VO2max或步行对APWV产生影响的身体活动阈值,大多数女性在研究开始时达到了这个阈值,但大多数男性已经超过了这个阈值。尽管这是一项二次分析,结果需要确认,但适度的身体活动可能对大血管结构有有益影响。