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血管疾病患者的体力活动与血管事件及死亡率

Physical Activity and Vascular Events and Mortality in Patients with Vascular Disease.

作者信息

Boss H Myrthe, Kappelle L Jaap, Van Der Graaf Yolanda, Kooistra Minke, Visseren Frank L J, Geerlings Mirjam I

机构信息

1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, THE NETHERLANDS; 2Department of Neurology, Sint Lucas Andreas Hospital, Amsterdam, THE NETHERLANDS; 3Department of Neurology, University Medical Center Utrecht, Utrecht, THE NETHERLANDS; and 4Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, THE NETHERLANDS.

出版信息

Med Sci Sports Exerc. 2015 Nov;47(11):2359-65. doi: 10.1249/MSS.0000000000000666.

Abstract

INTRODUCTION

In patients with CAD, moderate levels of leisure time physical activity are associated with lower risk of mortality. However, less is known about the effects in patients with vascular disease other than CAD. In this study, we examined the association between physical activity and risk of future vascular events and all-cause mortality in patients with vascular disease or risk factors and investigated whether these associations were similar across the different manifestations of vascular disease.

METHODS

A total of 9942 consecutive patients with various manifestations of vascular disease or risk factors enroled in the Second Manifestations of ARTerial disease study were included. The amount of physical activity was assessed at baseline in MET-hours per week.

RESULTS

The study population (mean age, 56.7 yr; male, 67%) had a median level of physical activity of 17.4 MET·h·wk(-1). During a median follow-up of 6.7 yr, 1224 vascular events and 1353 cases of all-cause mortality were recorded. Cox regression analyses adjusted for age, sex, smoking, and current alcohol consumption showed that higher levels of physical activity were associated with reduced risk of vascular events (quartile 4 vs quartile 1; hazard ratio, 0.68 (95% confidence interval, 0.58-0.79)) and all-cause mortality (hazard ratio, 0.61 (95% confidence interval, 0.53-0.71)). This reduced risk was observed both in patients with vascular disease and in patients with risk factors. The associations were similar across the different manifestations of vascular disease.

CONCLUSIONS

Higher levels of leisure time physical activity were associated with reduced risk of vascular events and all-cause mortality in patients with CAD and other manifestations of vascular disease, suggesting that physical exercise programs should also be investigated in these other manifestations.

摘要

引言

在冠心病患者中,适度的休闲时间体力活动与较低的死亡风险相关。然而,对于除冠心病之外的血管疾病患者的影响,我们了解得较少。在本研究中,我们调查了体力活动与血管疾病或危险因素患者未来发生血管事件的风险及全因死亡率之间的关联,并研究了这些关联在不同血管疾病表现中是否相似。

方法

纳入了动脉疾病二级表现研究中连续的9942例有各种血管疾病表现或危险因素的患者。在基线时以每周代谢当量小时数评估体力活动量。

结果

研究人群(平均年龄56.7岁;男性占67%)的体力活动中位数水平为17.4代谢当量·小时·周⁻¹。在中位随访6.7年期间,记录了1224例血管事件和1353例全因死亡病例。经年龄、性别、吸烟和当前饮酒情况校正的Cox回归分析显示,较高水平的体力活动与血管事件风险降低相关(四分位数4与四分位数1相比;风险比,0.68(95%置信区间,0.58 - 0.79))以及全因死亡率降低相关(风险比,0.61(95%置信区间,0.53 - 0.71))。在血管疾病患者和有危险因素的患者中均观察到这种风险降低。这些关联在不同血管疾病表现中相似。

结论

较高水平的休闲时间体力活动与冠心病及其他血管疾病表现患者的血管事件风险和全因死亡率降低相关,这表明在这些其他表现中也应研究体育锻炼项目。

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