van Stralen Karlijn J, Doggen Carine J M, Lumley Thomas, Cushman Mary, Folsom Aaron R, Psaty Bruce M, Siscovick David, Rosendaal Frits R, Heckbert Susan R
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
J Am Geriatr Soc. 2008 Mar;56(3):517-22. doi: 10.1111/j.1532-5415.2007.01588.x. Epub 2008 Jan 4.
To study whether exercise is associated with the risk of venous thrombosis in elderly people.
Observational study with a median follow-up of 11.6 years.
The Cardiovascular Health Study in four U.S. communities.
People aged 65 and older without prior venous thrombosis (deep venous thrombosis or pulmonary embolism).
Self-reported exercise was measured two or three times during follow-up and was defined as expending more than 500 kcal/wk on exercise, including walking for exercise. Venous thrombosis cases were verified using medical record review.
Of 5,534 participants, 171 developed a first venous thrombosis. Self-reported exercise at baseline was not related to the risk of venous thrombosis after adjustment for sex, age, race, self-reported health, and body mass index (adjusted hazard ratio (HR(adj))=1.16, 95% confidence interval (CI)=0.84-1.61), although with exercise modeled as a time-varying exposure, overall results were in the direction of greater risk of venous thrombosis (HR(adj)=1.38, 95% CI=0.99-1.91). For mild-intensity exercise, such as walking, there was a nonsignificant finding in the direction of benefit (HR(adj)=0.75, 95% CI=0.49-1.16), but strenuous exercise, such as jogging, was associated with greater risk of venous thrombosis (HR(adj)=1.75, 95% CI=1.08-2.83) than no exercise at all.
In elderly people, strenuous exercise was associated with a higher risk of venous thrombosis than no exercise at all. Future studies are needed to explain this unexpected higher risk.
研究运动是否与老年人静脉血栓形成风险相关。
中位随访时间为11.6年的观察性研究。
美国四个社区的心血管心血管形成心血管健康研究。
65岁及以上且既往无静脉血栓形成（深静脉血栓形成或肺栓塞）的人群。
随访期间对自我报告的运动进行了两到三次测量，定义为每周运动消耗超过500千卡，包括步行锻炼。静脉血栓形成病例通过病历审查进行核实。
在5534名参与者中，171人发生了首次静脉血栓形成。在对性别、年龄、种族、自我报告的健康状况和体重指数进行调整后，基线时自我报告的运动与静脉血栓形成风险无关（调整后的风险比（HR(adj)）=1.16，95%置信区间（CI）=0.84-1.61），尽管将运动作为随时间变化的暴露因素进行建模时，总体结果显示静脉血栓形成风险有增加的趋势（HR(adj)=1.38，95%CI=0.99-1.91）。对于轻度运动，如步行，有获益趋势但无显著差异（HR(adj)=0.75，95%CI=0.49-1.16），但剧烈运动，如慢跑，与静脉血栓形成风险增加相关（HR(adj)=1.75，95%CI=1.08-2.83），高于完全不运动。
在老年人中，剧烈运动比完全不运动与更高的静脉血栓形成风险相关。需要进一步的研究来解释这种意外的高风险。
