Division of Stroke and Critical Care, Department of Neurology, University of Southern California, Los Angeles, California, USA.
J Neurol Neurosurg Psychiatry. 2012 Feb;83(2):146-51. doi: 10.1136/jnnp-2011-300743. Epub 2011 Oct 21.
Little is known about the effects of a healthy lifestyle on mortality after stroke. This study assessed whether five healthy lifestyle factors had independent and dose dependent associations with all-cause and cardiovascular mortality after stroke.
In a nationally representative sample of the US population (n=15,299) with previous stroke (n=649) followed from survey participation (1988-1994) through to mortality assessment (2000), the relationship between five factors (eating ≥5 servings of fruits/vegetables per day, exercising >12 times/month, having a body mass index of 18.5-29.9 mg/kg(2), moderate alcohol use [1 drink/day for women and 2 drinks/day for men] and not smoking) and all-cause and cardiovascular mortality was assessed.
Mean age was 67.0 years (SE 1.1 years) and 53% were women. After adjusting for covariates, abstaining from smoking (HR 0.57, CI 0.34 to 0.98) and exercising regularly (HR 0.66, CI 0.44 to 0.99) were associated with lower all-cause mortality but no individual factors had independent associations with cardiovascular mortality. All-cause mortality decreased with higher numbers of healthy behaviours (1-3 factors vs none: HR 0.12, CI 0.03 to 0.47; 4-5 factors vs none: HR 0.04, CI 0.01 to 0.20; 4-5 factors vs 1-3 factors: HR 0.38, CI 0.22 to 0.66; trend p=0.04). Similar effects were observed for cardiovascular mortality (4-5 factors vs none: HR 0.08, CI 0.01 to 0.66; 1-3 factors vs none: HR 0.15, CI 0.02 to 1.15; 4-5 factors vs 1-3 factors: HR 0.53, CI 0.28 to 0.98; trend p=0.18).
Regular exercise and abstinence from smoking were independently associated with lower all-cause mortality after stroke. Combinations of healthy lifestyle factors were associated with lower all-cause and cardiovascular mortality in a dose dependent fashion.
关于健康生活方式对中风后死亡率的影响知之甚少。本研究评估了五种健康生活方式因素是否与中风后全因和心血管死亡率存在独立且剂量相关的关联。
在一项具有全国代表性的美国人群样本（n=15299）中，有既往中风（n=649），从参与调查（1988-1994 年）到进行死亡率评估（2000 年），评估了五种因素（每天食用≥5 份水果/蔬菜、每月运动>12 次、身体质量指数为 18.5-29.9mg/kg(2)、适量饮酒[女性 1 份/天，男性 2 份/天]和不吸烟）与全因和心血管死亡率之间的关系。
平均年龄为 67.0 岁（SE 1.1 岁），53%为女性。在调整了混杂因素后，不吸烟（HR 0.57，CI 0.34 至 0.98）和经常锻炼（HR 0.66，CI 0.44 至 0.99）与全因死亡率降低相关，但没有任何单一因素与心血管死亡率独立相关。随着健康行为数量的增加，全因死亡率下降（1-3 个因素与无因素相比：HR 0.12，CI 0.03 至 0.47；4-5 个因素与无因素相比：HR 0.04，CI 0.01 至 0.20；4-5 个因素与 1-3 个因素相比：HR 0.38，CI 0.22 至 0.66；趋势 p=0.04）。心血管死亡率也观察到类似的效果（4-5 个因素与无因素相比：HR 0.08，CI 0.01 至 0.66；1-3 个因素与无因素相比：HR 0.15，CI 0.02 至 1.15；4-5 个因素与 1-3 个因素相比：HR 0.53，CI 0.28 至 0.98；趋势 p=0.18）。
定期锻炼和不吸烟与中风后全因死亡率降低独立相关。健康生活方式因素的组合以剂量依赖的方式与全因和心血管死亡率降低相关。
