Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, PA.
Med Sci Sports Exerc. 2021 Apr 1;53(4):732-739. doi: 10.1249/MSS.0000000000002526.
This study aimed to determine the association between light-intensity physical activity and the incidence of all-cause and cardiovascular mortality in patients with peripheral artery disease (PAD) limited by claudication followed for up to 18.7 yr.
A total of 528 patients with PAD and claudication were screened in Baltimore between 1994 and 2002, and 386 were deemed eligible for the study. At baseline, patients were classified into three physical activity groups: 1) physically sedentary, 2) light intensity, and 3) moderate to vigorous intensity based on a questionnaire. All-cause and cardiovascular mortality of patients through December 2014 was determined using the National Death Index and the U.S. Department of Veterans Affairs and the U.S. Department of Defense Suicide Data Repository.
Median survival time was 9.9 yr (interquartile range, 4.9-15.7 yr; range, 0.38-18.7 yr). During follow-up, 257 patients (66.6%) died, consisting of 40/48 (83.3%) from the sedentary group, 135/210 (64.3%) from the light-intensity group, and 82/128 (64.0%) from the moderate- to vigorous-intensity group. For all-cause mortality, light-intensity activity status (hazard ratio [HR] = 0.523, P = 0.0007) and moderate- to vigorous-intensity status (HR = 0.425, P < 0.0001) were significant predictors. During follow-up, 125 patients died because of cardiovascular causes (32.4%), in which light-intensity activity status (HR = 0.511, P = 0.0113) and moderate- to vigorous-intensity activity status (HR = 0.341, P = 0.0003) were significant predictors.
Light-intensity physical activity is associated with nearly 50% lower risk of all-cause and cardiovascular mortality in high-risk patients with PAD and claudication. Furthermore, moderate- to vigorous-intensity physical activity performed regularly is associated with 58% and 66% lower risk of all-cause and cardiovascular mortality, respectively. The survival benefits associated with light-intensity physical activity make it a compelling behavioral intervention that extends beyond improving ambulation.
本研究旨在确定轻强度体力活动与因外周动脉疾病（PAD）导致的所有原因和心血管死亡率之间的关联，PAD 患者的跛行限制，随访时间长达 18.7 年。
1994 年至 2002 年在巴尔的摩对 528 名 PAD 和跛行患者进行了筛查，其中 386 名患者被认为符合研究条件。在基线时，根据问卷将患者分为三组体力活动：1）久坐，2）低强度，和 3）中高强度。通过国家死亡指数和美国退伍军人事务部和美国国防部自杀数据存储库确定患者截至 2014 年 12 月的全因和心血管死亡率。
中位生存时间为 9.9 年（四分位距，4.9-15.7 年；范围，0.38-18.7 年）。随访期间，257 名患者（66.6%）死亡，其中 40/48（83.3%）来自久坐组，135/210（64.3%）来自低强度组，82/128（64.0%）来自中高强度组。对于全因死亡率，低强度活动状态（危险比[HR] = 0.523，P = 0.0007）和中高强度状态（HR = 0.425，P <0.0001）是显著的预测因素。在随访期间，有 125 名患者因心血管原因死亡（32.4%），其中低强度活动状态（HR = 0.511，P = 0.0113）和中高强度活动状态（HR = 0.341，P = 0.0003）是显著的预测因素。
在有 PAD 和跛行的高危患者中，低强度体力活动与全因和心血管死亡率降低近 50%相关。此外，定期进行中高强度体力活动分别与全因和心血管死亡率降低 58%和 66%相关。与低强度体力活动相关的生存获益使其成为一种引人注目的行为干预措施，不仅可以改善活动能力。
