Williams Paul T, Franklin Barry A
Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California.
Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Beaumont Health Center, Royal Oak, Michigan.
Am J Cardiol. 2015 Nov 15;116(10):1516-20. doi: 10.1016/j.amjcard.2015.08.011. Epub 2015 Aug 31.
Exercise may be an important treatment for hypercholesterolemic patients, particularly in statin users who are at increased diabetes risk. We therefore used Cox proportional hazard analyses to compare running and walking dose (metabolic equivalent hours/day [MET-h/d]) to diabetes, hypertension, and cardiovascular disease (CVD) risk in hypercholesterolemic patients. There were 60 diabetic- and 373 CVD-related deaths during a 10.1-year mortality surveillance of 6,688 hypercholesterolemic patients. In addition, there were 177 incident nonfatal diabetes, 815 incident nonfatal hypertensions, and 323 incident nonfatal CVD events during a 6.4-year follow-up of 6,971 hypercholesterolemic patients who supplied follow-up questionnaires. Fatal and nonfatal diabetes risk decreased 26% (p = 0.002) and 19% (p ≤0.0001) per MET-h/d, respectively, and relative to <1.07 MET-h/d decreased 35% (p = 0.19) and 55% (p ≤0.0001), respectively, for 1.8 to 3.6 MET-h/d and 73% (p = 0.02) and 71% (p ≤0.0001), respectively, for ≥3.6 MET-h/d. Fatal and nonfatal CVD risk decreased 8% (p = 0.008) and 3% (p = 0.22) per MET-h/d, respectively, and relative to <1.07 MET-h/d decreased 10% (p = 0.45) and 36% (p = 0.008) for 1.8 to 3.6 MET-h/d, respectively, and 37% (p = 0.009) and 26% (p = 0.10), respectively, for ≥3.6 MET-h/d. Incident hypertension risk decreased 4% (p = 0.01) per MET-h/d, and relative to <1.07 MET-h/d decreased 29% (p = 0.002) for 1.8 to 3.6 MET-h/d and 31% (p = 0.001) for ≥3.6 MET-h/d. In conclusion, running and walking for exercise lowers diabetes, hypertension, and CVD risk in hypercholesterolemic patients and should more than compensate for the purported 9% increase in diabetes risk from statin use. By preventing morbidity and mortality for a specific existing medical condition, some exercise expenses may qualify for flexible spending account expenditures in hypercholesterolemic patients when prescribed by a physician.
运动可能是高胆固醇血症患者的一种重要治疗方法，尤其对于那些使用他汀类药物且糖尿病风险增加的患者。因此，我们使用Cox比例风险分析来比较高胆固醇血症患者的跑步和步行剂量（代谢当量小时/天[MET-h/d]）与糖尿病、高血压和心血管疾病（CVD）风险。在对6688名高胆固醇血症患者进行的10.1年死亡率监测期间，有60例糖尿病相关死亡和373例CVD相关死亡。此外，在对6971名提供随访问卷的高胆固醇血症患者进行的6.4年随访期间，有177例新发非致命性糖尿病、815例新发非致命性高血压和323例新发非致命性CVD事件。每增加1 MET-h/d，致命性和非致命性糖尿病风险分别降低26%（p = 0.002）和19%（p≤0.0001），相对于<1.07 MET-h/d，1.8至3.6 MET-h/d时分别降低35%（p = 0.19）和55%（p≤0.0001），≥3.6 MET-h/d时分别降低73%（p = 0.02）和71%（p≤0.0001）。每增加1 MET-h/d，致命性和非致命性CVD风险分别降低8%（p = 0.008）和3%（p = 0.22），相对于<1.07 MET-h/d，1.8至3.6 MET-h/d时分别降低10%（p = 0.45）和36%（p = 0.008），≥3.6 MET-h/d时分别降低37%（p = 0.009）和26%（p = 0.10）。新发高血压风险每增加1 MET-h/d降低4%（p = 0.01），相对于<1.07 MET-h/d，1.8至3.6 MET-h/d时降低29%（p = 0.002），≥3.6 MET-h/d时降低31%（p = 0.001）。总之，跑步和步行锻炼可降低高胆固醇血症患者的糖尿病、高血压和CVD风险，并且应该足以弥补使用他汀类药物据称增加的9%糖尿病风险。通过预防特定现有医疗状况的发病和死亡，当由医生开处方时，一些运动费用可能符合高胆固醇血症患者灵活支出账户支出的条件。
