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老年人运动与静脉血栓形成风险之间的关系。

The relationship between exercise and risk of venous thrombosis in elderly people.

作者信息

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

机构信息

Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

J Am Geriatr Soc. 2008 Mar;56(3):517-22. doi: 10.1111/j.1532-5415.2007.01588.x. Epub 2008 Jan 4.

Abstract

OBJECTIVES

To study whether exercise is associated with the risk of venous thrombosis in elderly people.

DESIGN

Observational study with a median follow-up of 11.6 years.

SETTING

The Cardiovascular Health Study in four U.S. communities.

PARTICIPANTS

People aged 65 and older without prior venous thrombosis (deep venous thrombosis or pulmonary embolism).

MEASUREMENTS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

研究运动是否与老年人静脉血栓形成风险相关。

设计

中位随访时间为11.6年的观察性研究。

地点

美国四个社区的心血管心血管形成心血管健康研究。

参与者

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。

测量

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。

结果

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。

结论

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。

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