Institute of Cardiovascular and Medical Sciences, United Kingdom.
Institute of Cardiovascular and Medical Sciences, United Kingdom.
Mayo Clin Proc. 2019 Nov;94(11):2230-2240. doi: 10.1016/j.mayocp.2019.04.041.
To investigate the associations of objectively measured cardiorespiratory fitness (CRF) and grip strength (GS) with incident heart failure (HF), a clinical syndrome that results in substantial social and economic burden, using UK Biobank data.
Of the 502,628 participants recruited into the UK Biobank between April 1, 2007, and December 31, 2010, a total of 374,493 were included in our GS analysis and 57,053 were included in CRF analysis. Associations between CRF and GS and incident HF were investigated using Cox proportional hazard models, with adjustment for known measured confounders.
During a mean of 4.1 (range, 2.4-7.1) years, 631 HF events occurred in those with GS data, and 66 HF events occurred in those with CRF data. Higher CRF was associated with 18% lower risk for HF (hazard ratio [HR], 0.82; 95% CI, 0.76-0.88) per 1-metabolic equivalent increment increase and GS was associated with 19% lower incidence of HF risk (HR, 0.81; 95% CI, 0.77-0.86) per 5-kg increment increase. When CRF and GS were standardized, the HR for CRF was 0.50 per 1-SD increment (95% CI, 0.38-0.65), and for GS was 0.65 per 1-SD increment (95% CI, 0.58-0.72).
Our data indicate that objective measurements of physical function (GS and CRF) are strongly and independently associated with lower HF incidence. Future studies targeting improving CRF and muscle strength should include HF as an outcome to assess whether these results are causal.
利用英国生物库的数据,研究通过客观测量得到的心肺功能(CRF)和握力(GS)与心力衰竭(HF)发病的关联。HF 是一种导致巨大社会和经济负担的临床综合征。
在 2007 年 4 月 1 日至 2010 年 12 月 31 日期间招募的英国生物库 502628 名参与者中,共有 374493 人纳入 GS 分析,57053 人纳入 CRF 分析。采用 Cox 比例风险模型研究 CRF 和 GS 与 HF 发病的相关性,调整已知的测量混杂因素。
在平均 4.1 年(范围:2.4-7.1 年)的随访期间,有 GS 数据的参与者中发生 631 例 HF 事件,有 CRF 数据的参与者中发生 66 例 HF 事件。每增加 1 个代谢当量,CRF 降低 HF 风险 18%(风险比 [HR],0.82;95%CI,0.76-0.88),每增加 5kg,GS 降低 HF 风险 19%(HR,0.81;95%CI,0.77-0.86)。当 CRF 和 GS 标准化后,CRF 的 HR 为每 1-SD 增量 0.50(95%CI,0.38-0.65),GS 的 HR 为每 1-SD 增量 0.65(95%CI,0.58-0.72)。
我们的数据表明,身体功能的客观测量(GS 和 CRF)与 HF 发病率降低密切相关且独立相关。未来针对提高 CRF 和肌肉力量的研究应将 HF 作为评估结果的一种结局,以确定这些结果是否具有因果关系。