一般人群中客观测量的身体活动与心血管老化的关系——EVIDENT 试验。
Relationship between objectively measured physical activity and cardiovascular aging in the general population--the EVIDENT trial.
机构信息
The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain.
Division Sports and Exercise Medicine, Institute of Exercise and Health Sciences, University of Basel, Switzerland.
出版信息
Atherosclerosis. 2014 Apr;233(2):434-440. doi: 10.1016/j.atherosclerosis.2014.01.021. Epub 2014 Jan 24.
BACKGROUND
Aging has been associated with an increase in arterial stiffness. We analyzed the relationship between regular physical activity and cardiovascular aging evaluated by the radial augmentation index (rAIx), ambulatory arterial stiffness index (AASI), pulse pressure (PP) and heart age in subjects without atherosclerotic disease.
METHODS
A cross-sectional study was performed including 1365 subjects from the EVIDENT trial (mean age 54.9±13.7 years; 60.3% women). As a measure of total volume of physical activity we used counts/minute recorded in an accelerometer (Actigraph GT3X) that participants wore for seven days, collecting data in 60-sec epochs, and respondents with ≥4 valid days were retained for the analysis. Arterial stiffness was evaluated using measures of rAIx, AASI, and central and peripheral PP on the B-pro device. rAIx was adjusted to 75 heart rate(rAIx75). Cardiovascular risk and heart age was estimated by the Framingham Risk Score.
RESULTS
The median (IQR) of counts/min was 236.9 (176.3-307.8), rAIx75 90 (77-100), sleep PP 40 mmHg (33-47), central PP 39 mmHg (32-47) and heart age 57 years (45-73) and the mean±SD of the ASSI was 0.44±0.07. We found an inverse correlation between counts/minute and rAIx75 (r=-0.086; p<0.01), AASI (r=-0.146; p<0.001), heart age (r=-0.163; p<0.001) and peripherals PP. These associations were remained after controlling for potential confounders, except for rAIx75. In the multiple regression analysis, after adjustment, an inverse association persisted between counts/minute and AASI, sleep PP and heart age, but not with rAIx75. Accordingly, for every 100 higher counts/minute of accelerometer measures, both AASI and sleep PP would be lower by one measurement unit (beta=-0.979 and -1.031 respectively, p<0.001) and the estimated heart age by half year (beta=-0.525, p=0.023).
CONCLUSIONS
Regular physical activity was inversely associated with parameters related to advanced cardiovascular aging after adjustment for potentially influencing variables.
TRIAL REGISTRATION
Clinical Trials.gov Identifier: NCT01083082.
背景
衰老与动脉僵硬度增加有关。我们分析了在无动脉粥样硬化疾病的受试者中，定期体力活动与桡动脉增强指数（rAIx）、动态动脉僵硬指数（AASI）、脉压（PP）和心脏年龄评估的心血管老化之间的关系。
方法
进行了一项横断面研究，纳入了 EVIDENT 试验中的 1365 名受试者（平均年龄 54.9±13.7 岁；60.3%为女性）。我们使用加速度计（Actigraph GT3X）记录的每分钟计数来衡量总体力活动量，参与者佩戴加速度计 7 天，以 60 秒为一个数据采集周期，保留至少 4 天有效数据的受访者进行分析。使用 B-pro 设备评估 rAIx、AASI 以及中心和外周 PP 的动脉僵硬度。rAIx 调整至心率 75 次时的 rAIx（rAIx75）。Framingham 风险评分估计心血管风险和心脏年龄。
结果
每分钟计数的中位数（IQR）为 236.9（176.3-307.8），rAIx75 为 90（77-100），睡眠时 PP 为 40mmHg（33-47），中心 PP 为 39mmHg（32-47），心脏年龄为 57 岁（45-73），ASSI 的平均值±标准差为 0.44±0.07。我们发现每分钟计数与 rAIx75（r=-0.086；p<0.01）、AASI（r=-0.146；p<0.001）、心脏年龄（r=-0.163；p<0.001）和外周 PP 呈负相关。在控制潜在混杂因素后，这些相关性仍然存在，但 rAIx75 除外。在多元回归分析中，经调整后，每分钟计数与 AASI、睡眠时 PP 和心脏年龄之间仍存在负相关，但与 rAIx75 无关。因此，加速度计测量的每分钟计数每增加 100，AASI 和睡眠时 PP 会分别降低 1 个测量单位（β=-0.979 和-1.031，均 p<0.001），心脏年龄会降低 0.525 年（β=-0.525，p=0.023）。
结论
在调整潜在影响因素后，定期体力活动与先进的心血管老化参数呈负相关。
试验注册
ClinicalTrials.gov 标识符：NCT01083082。
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