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老年普通人群中的心血管疾病、风险因素及短期心率变异性:2002 - 2006年CARLA研究

Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002-2006.

作者信息

Greiser Karin Halina, Kluttig Alexander, Schumann Barbara, Swenne Cees A, Kors Jan A, Kuss Oliver, Haerting Johannes, Schmidt Hendrik, Thiery Joachim, Werdan Karl

机构信息

Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany.

出版信息

Eur J Epidemiol. 2009;24(3):123-42. doi: 10.1007/s10654-009-9317-z. Epub 2009 Feb 7.

Abstract

BACKGROUND

A reduced heart rate variability (HRV) is associated with worse prognosis, increased incidence of cardiovascular disease (CVD) and mortality. There are conflicting results and a lack of population-based data regarding the association of HRV with CVD risk factors and its potential role as independent cause or mediator of CVD risk.

METHODS

Cross-sectional data of a population-based cohort including 1,779 women and men aged 45-83 years were used to analyse associations of time and frequency domain measures of HRV (derived from 5-min ECG segments) with age, behavioural and biomedical risk factors and disease in the whole sample and in a "healthy" subgroup.

RESULTS

Age was inversely associated with all measures of HRV (mean standard deviation of normal intervals across 10-year age-groups 32.1, 26.9, 27.1 and 24.8 ms in women, 29.3, 25.9, 23.8 and 25.7 ms in men). There was no association of physical activity, current smoking or alcohol with HRV. In age-adjusted models, triglycerides, glucose, waist-to-hip ratio and diabetes were inversely associated with HRV in men and women, and low/high density cholesterol and hypertension in men only (up to 43% difference across risk factor quartiles). Multivariable adjustment and restriction to the "healthy" subgroup attenuated the associations.

CONCLUSIONS

We found only weak and inconsistent associations of HRV with cardiovascular risk factors. However, these results as well as those from previous studies are still compatible with the hypothesis that short-term HRV may be a marker of ill health or a mediator of the effect of selected biomedical risk factors on CVD.

摘要

背景

心率变异性(HRV)降低与预后较差、心血管疾病(CVD)发病率增加及死亡率升高相关。关于HRV与CVD危险因素的关联及其作为CVD风险独立病因或介导因素的潜在作用,存在相互矛盾的结果且缺乏基于人群的数据。

方法

基于人群队列的横断面数据,包括1779名年龄在45 - 83岁的男性和女性,用于分析HRV的时域和频域测量指标(源自5分钟心电图片段)与整个样本及“健康”亚组中的年龄、行为和生物医学危险因素及疾病之间的关联。

结果

年龄与HRV的所有测量指标呈负相关(女性10岁年龄组的正常间期平均标准差分别为32.1、26.9、27.1和24.8毫秒,男性为29.3、25.9、23.8和25.7毫秒)。体力活动、当前吸烟或饮酒与HRV无关联。在年龄调整模型中,甘油三酯、血糖、腰臀比和糖尿病与男性和女性的HRV呈负相关,而低密度/高密度胆固醇和高血压仅与男性的HRV呈负相关(各危险因素四分位数间差异高达43%)。多变量调整及对“健康”亚组的限制减弱了这种关联。

结论

我们发现HRV与心血管危险因素之间的关联微弱且不一致。然而,这些结果以及先前研究的结果仍与以下假设相符,即短期HRV可能是健康状况不佳的标志物或所选生物医学危险因素对CVD影响的介导因素。

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