Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena.
Circ Heart Fail. 2014 Jan;7(1):21-7. doi: 10.1161/CIRCHEARTFAILURE.113.000529.
Although the benefits of physical activity for risk of coronary heart disease are well established, less is known about its effects on heart failure (HF). The risk of prolonged sedentary behavior on HF is unknown.
The study cohort included 82 695 men aged≥45 years from the California Men's Health Study without prevalent HF who were followed up for 10 years. Physical activity, sedentary time, and behavioral covariates were obtained from questionnaires, and clinical covariates were determined from electronic medical records. Incident HF was identified through International Classification of Diseases, Ninth Revision codes recorded in electronic records. During a mean follow-up of 7.8 years (646 989 person-years), 3473 men were diagnosed with HF. Controlling for sedentary time, sociodemographics, hypertension, diabetes mellitus, unfavorable lipid levels, body mass index, smoking, and diet, the hazard ratio (95% confidence interval [CI]) of HF in the lowest physical activity category compared with those in the highest category was 1.52 (95% CI, 1.39-1.68). Those in the medium physical activity category were also at increased risk (hazard ratio, 1.17 [95% CI, 1.06-1.29]). Controlling for the same covariates and physical activity, the hazard ratio (95% CI) of HF in the highest sedentary category compared with the lowest was 1.34 (95% CI, 1.21-1.48). Medium sedentary time also conveyed risk (hazard ratio, 1.13 [95% CI, 1.04-1.24]). Results showed similar trends across white and Hispanic subgroups, body mass index categories, baseline hypertension status, and prevalent coronary heart disease.
Both physical activity and sedentary time may be appropriate intervention targets for preventing HF.
虽然身体活动有益于降低冠心病风险已得到充分证实，但对于其对心力衰竭（HF）的影响知之甚少。久坐行为对 HF 的长期影响尚不清楚。
研究队列包括来自加利福尼亚男性健康研究的 82695 名年龄≥45 岁、无既往 HF 的男性，随访时间为 10 年。身体活动、久坐时间和行为协变量通过问卷获得，临床协变量通过电子病历确定。通过电子记录中的国际疾病分类，第九修订版代码确定 HF 的发生。在平均 7.8 年（646989 人年）的随访期间，有 3473 名男性被诊断为 HF。控制久坐时间、社会人口统计学因素、高血压、糖尿病、血脂异常、体重指数、吸烟和饮食因素后，与最高活动类别相比，最低活动类别的 HF 发生风险比（95%置信区间[CI]）为 1.52（95%CI，1.39-1.68）。中等身体活动类别的风险也有所增加（风险比，1.17[95%CI，1.06-1.29]）。在控制相同的协变量和身体活动后，与最低久坐时间相比，最高久坐时间的 HF 发生风险比（95%CI）为 1.34（95%CI，1.21-1.48）。中等久坐时间也有风险（风险比，1.13[95%CI，1.04-1.24]）。结果表明，在白人、西班牙裔亚组、体重指数类别、基线高血压状态和既往冠心病患者中，均显示出相似的趋势。
身体活动和久坐时间都可能是预防 HF 的合适干预靶点。
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