Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD.
Center on Aging and Health Johns Hopkins University Baltimore MD.
J Am Heart Assoc. 2019 Aug 20;8(16):e013049. doi: 10.1161/JAHA.119.013049. Epub 2019 Aug 14.
Background Cardiovascular disease (CVD) and fatigue commonly co-occur in older adults, yet the subjective nature of fatigue and its situational dependence leave the true magnitude of this association undefined. Methods and Results Six-hundred and twenty-five participants with no history of CVD (aged 68.1+12.0 years), from the Baltimore Longitudinal Study of Aging who underwent ≥2 clinic visits between 2007 and 2015 were classified according to sex-specific predicted 10-year CVD risk scores using the Framingham CVD risk score (Framingham) and the Pooled Cohort Equation at baseline. Perceived fatigability was assessed using the Borg rating of perceived exertion scale after a 5-minute treadmill walk (0.67 m/s, 0% grade). Linear models were used to assess the association between baseline CVD risk and perceived fatigability an average of 4.5 years later, adjusted for demographics, behaviors, and medical history. In final models, a 5% higher baseline Pooled Cohort Equation score was associated with greater perceived fatigability at follow-up (β=0.13 rating of perceived exertion, P=0.008). Stratified analyses suggested this association was stronger among those aged ≤70 years and those with obesity. Of the individual CVD risk score components, older age was most strongly associated with perceived fatigability (β=0.48, P<0.001), followed by women (β=0.11, P=0.002), and treated hypertension (β=0.11, P=0.003). There was no association with the Framingham risk score. Conclusions Perceived fatigability was higher among participants with greater CVD risk measured using the Pooled Cohort Equation risk score. The strong associations with hypertension and obesity suggest prevention and promotion of cardiovascular health may also lower perceived fatigability, particularly among those aged ≤70 years or living with obesity.
心血管疾病（CVD）和疲劳在老年人中常同时发生，但疲劳的主观性及其对情境的依赖性使得这种关联的真实程度无法确定。
在 2007 年至 2015 年间进行了≥2 次就诊的、无 CVD 病史的 625 名参与者（年龄 68.1+12.0 岁），根据性别特异性预测的 10 年 CVD 风险评分，使用 Framingham CVD 风险评分（Framingham）和基线时的 Pooled Cohort 方程进行分类。使用 Borg 感觉用力量表评估在 5 分钟跑步机步行（0.67 m/s，0%坡度）后的疲劳感。使用线性模型评估基线 CVD 风险与平均 4.5 年后感知疲劳之间的关联，调整了人口统计学、行为和病史因素。在最终模型中，基线 Pooled Cohort 方程评分每增加 5%，与随访时感知疲劳的增加相关（β=0.13 感觉用力评分，P=0.008）。分层分析表明，这种关联在≤70 岁的人群和肥胖人群中更强。在个体 CVD 风险评分成分中，年龄较大与感知疲劳的关联最强（β=0.48，P<0.001），其次是女性（β=0.11，P=0.002）和接受治疗的高血压（β=0.11，P=0.003）。Framingham 风险评分与感知疲劳无关。
使用 Pooled Cohort 方程风险评分测量的 CVD 风险较高的参与者感知疲劳程度更高。与高血压和肥胖的强烈关联表明，预防和促进心血管健康也可能降低感知疲劳，特别是在≤70 岁或肥胖的人群中。
