生活简单 7 心血管健康评分与房性期前收缩：社区动脉粥样硬化风险（ARIC）研究。
Life's Simple 7 cardiovascular health score and premature atrial contractions: The atherosclerosis risk in communities (ARIC) study.
机构信息
Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States of America.
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America.
出版信息
Int J Cardiol. 2021 Jun 1;332:70-77. doi: 10.1016/j.ijcard.2021.02.083. Epub 2021 Mar 4.
BACKGROUND
Premature atrial contractions (PACs) are associated with increased risk of atrial fibrillation (AF) and ischemic stroke. Although lifestyle and risk factor modification reduces AF incidence, their relationship to PACs frequency is unclear. We assessed the association of Life's Simple 7 (LS7) and individual LS7 factors in midlife with PACs frequency in late life in the Atherosclerosis Risk in Communities (ARIC) Study.
METHODS
We followed 1924 participants from ARIC clinic Visit 3 (1993--95) to Visit 6 (2016-17) when a 2-week continuous heart rhythm monitor (Zio®XT Patch) was applied. LS7 factors were assessed at Visit 3 and a composite score was calculated. PACs frequency was categorized as minimal (<0.1%), occasional (≥0.1%-5%) and frequent (>5%). Logistic regression was used to evaluate the association of LS7 score and individual factors with PACs frequency.
RESULTS
Each 1-point LS7 score increase was associated with lower odds of frequent PACs vs. no PACs (OR [95% CI]: 0.87 [0.78, 0.98]) and frequent PACs vs. occasional PACs (OR [95% CI]: 0.88 [0.79, 0.98]). Of the individual LS7 factors, compared with ideal physical activity, poor physical activity was associated with 81% higher odds of frequent PACs vs. no PACs. Compared with ideal BMI, poor BMI was associated with 41% higher odds of occasional PACs vs. no PACs.
CONCLUSION
Lifestyle risk factors, particularly physical activity and BMI, are associated with higher odds of PACs frequency. More research is needed to determine whether modifying these risk factors in midlife would prevent frequent PACs, and thereby prevent AF and stroke in older age.
背景
房性期前收缩（PACs）与心房颤动（AF）和缺血性中风的风险增加有关。虽然生活方式和危险因素的改变可以降低 AF 的发生率，但它们与 PACs 频率的关系尚不清楚。我们评估了 Life's Simple 7（LS7）和中年时 LS7 个体因素与 Atherosclerosis Risk in Communities（ARIC）研究中晚年 PACs 频率的相关性。
方法
我们对 1924 名参与者进行了随访，这些参与者参加了 ARIC 诊所的第三次（1993-95 年）和第六次（2016-17 年）检查，在这两次检查中应用了为期两周的连续心脏节律监测仪（Zio®XT 贴片）。LS7 因素在第三次检查时进行评估，并计算了综合评分。PACs 频率分为最低（<0.1%）、偶尔（≥0.1%-5%）和频繁（>5%）。使用逻辑回归评估 LS7 评分和个体因素与 PACs 频率的关系。
结果
LS7 评分每增加 1 分，与无 PACs 相比，频繁 PACs 的可能性降低（OR[95%CI]：0.87[0.78, 0.98]），与偶尔 PACs 相比，频繁 PACs 的可能性降低（OR[95%CI]：0.88[0.79, 0.98]）。在 LS7 的个体因素中，与理想的体力活动相比，较差的体力活动与频繁 PACs 的可能性增加 81%有关（OR[95%CI]：0.81[0.72, 0.91]）。与理想的 BMI 相比，较差的 BMI 与偶尔 PACs 的可能性增加 41%有关（OR[95%CI]：0.88[0.78, 0.98]）。
结论
生活方式危险因素，特别是体力活动和 BMI，与 PACs 频率的可能性增加有关。需要进一步研究确定在中年期改变这些危险因素是否会预防频繁的 PACs，从而预防老年时的 AF 和中风。
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