Population Science, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
Circulation. 2010 Jan 19;121(2):237-44. doi: 10.1161/CIRCULATIONAHA.109.887893. Epub 2010 Jan 4.
Obesity increases heart failure (HF) risk; however, the independent effect of physical activity and the joint effect of physical activity and adiposity on HF risk are not established. We evaluated the single and joint associations of physical activity and different indicators of adiposity (body mass index, waist circumference, and waist-to-hip ratio) with HF risk.
Study cohorts included 59 178 Finnish participants who were 25 to 74 years of age and free of HF at baseline. During a mean follow-up of 18.4 years, 1921 men and 1693 women developed HF. The multivariable-adjusted hazard ratios of HF associated with low, moderate, and high physical activity were 1.00, 0.79, and 0.69 (P(trend)<0.001) for men and 1.00, 0.86, and 0.68 (P(trend)<0.001) for women, respectively. The multivariable-adjusted hazard ratios of HF at different levels of body mass index (<25, 25 to 29.9, and >or=30 kg/m(2)) were 1.00, 1.25, and 1.99 (P(trend)<0.001) for men and 1.00, 1.33, and 2.06 (P(trend)<0.001) for women, respectively. Abdominal adiposity, measured by waist circumference or waist-to-hip ratio, was associated with a greater risk of HF among both men and women (all P(trend)<0.01). In joint analyses, the protective effect of physical activity was consistent in subjects at all levels of body mass index.
General overweight and general and abdominal obesity are independently associated with an increased risk of HF, whereas moderate or high levels of physical activity are associated with a reduced risk of HF. The protective effect of physical activity on HF risk is observed at all levels of body mass index.
肥胖会增加心力衰竭（HF）的风险；然而，身体活动的独立影响以及身体活动和肥胖对 HF 风险的联合影响尚不确定。我们评估了身体活动和不同肥胖指标（体重指数、腰围和腰臀比）对 HF 风险的单一和联合关联。
研究队列包括 59178 名年龄在 25 至 74 岁之间且基线时无 HF 的芬兰参与者。在平均 18.4 年的随访期间，有 1921 名男性和 1693 名女性发生 HF。多变量调整后的 HF 风险比与男性的低、中、高强度身体活动相关的分别为 1.00、0.79 和 0.69（P<0.001），与女性的分别为 1.00、0.86 和 0.68（P<0.001）。不同 BMI 水平（<25、25-29.9 和≥30 kg/m2）的 HF 多变量调整后的风险比分别为男性的 1.00、1.25 和 1.99（P<0.001）和女性的 1.00、1.33 和 2.06（P<0.001）。腰围或腰臀比测量的腹部肥胖与男性和女性 HF 风险增加相关（所有 P<0.01）。在联合分析中，身体活动的保护作用在所有 BMI 水平的受试者中是一致的。
一般超重以及全身和腹部肥胖与 HF 风险增加独立相关，而中高强度的身体活动与 HF 风险降低相关。身体活动对 HF 风险的保护作用在所有 BMI 水平都存在。
