包含睡眠时长和心血管疾病风险的健康生活方式评分。
Healthy Lifestyle Score Including Sleep Duration and Cardiovascular Disease Risk.
机构信息
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine Research, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
出版信息
Am J Prev Med. 2022 Jul;63(1):33-42. doi: 10.1016/j.amepre.2022.01.027. Epub 2022 Mar 28.
INTRODUCTION
Although insufficient or prolonged sleep duration is associated with cardiovascular disease, sleep duration is not included in most lifestyle scores. This study evaluates the relationship between a lifestyle score, including sleep duration and cardiovascular disease risk.
METHODS
A prospective analysis among 67,250 women in the Nurses' Health Study and 29,114 men in Health Professionals Follow-up Study (1986-2016) was conducted in 2021. Lifestyle factors were updated every 2-4 years using self-reported questionnaires. The traditional lifestyle score was defined as not smoking, having a normal BMI, being physically active (≥30 minutes/day of moderate physical activity), eating a healthy diet, and drinking alcohol in moderation. Low-risk sleep duration, defined as sleeping ≥6 to <8 hours/day, was included as an additional component in the updated lifestyle score. Cox proportional hazard regression models were used to estimate cardiovascular disease risk. The likelihood-ratio test and C-statistics were used to compare both scores.
RESULTS
A total of 11,710 incident cardiovascular disease cases during follow-up were documented. The multivariable-adjusted hazard ratios comparing 6 with 0 low-risk factors in the healthy lifestyle score including sleep duration were 0.17 (95% CI=0.12, 0.23) for cardiovascular disease, 0.14 (95% CI=0.10, 0.21) for coronary heart disease, and 0.20 (95% CI=0.12, 0.33) for stroke. Approximately 66% (95% CI=56%, 75%) of cardiovascular disease, 67% (95% CI=54%, 77%) of coronary heart disease, and 62% (95% CI=42%, 76%) of stroke cases were attributable to poor adherence to a healthy lifestyle including sleep. Adding sleep duration to the score slightly increased the C-statistics from 0.64 (95% CI=0.63, 0.64) to 0.65 (95% CI=0.64, 0.65) (p<0.001).
CONCLUSIONS
Adopting a healthy lifestyle including sleep recommendations could substantially reduce the risk of cardiovascular disease in U.S. adults.
简介
尽管睡眠时长不足或过长与心血管疾病有关，但在大多数生活方式评分中并未纳入睡眠时长这一因素。本研究旨在评估包含睡眠时长的生活方式评分与心血管疾病风险之间的关系。
方法
2021 年对护士健康研究中的 67250 名女性和健康专业人员随访研究中的 29114 名男性进行了前瞻性分析（1986-2016 年）。生活方式因素每 2-4 年通过自我报告问卷进行更新。传统的生活方式评分定义为不吸烟、体重指数正常、身体活动（每天≥30 分钟中等强度的身体活动）、饮食健康和适量饮酒。将低风险的睡眠时长（定义为每天睡眠 6-7.9 小时）纳入更新后的生活方式评分中作为额外组成部分。使用 Cox 比例风险回归模型估计心血管疾病风险。采用似然比检验和 C 统计量比较两种评分。
结果
随访期间共记录到 11710 例心血管疾病事件。多变量调整后的危险比比较了健康生活方式评分（包括睡眠时长）中包含 6 个与 0 个低风险因素的情况，结果显示心血管疾病为 0.17（95%CI=0.12，0.23），冠心病为 0.14（95%CI=0.10，0.21），中风为 0.20（95%CI=0.12，0.33）。大约 66%（95%CI=56%，75%）的心血管疾病、67%（95%CI=54%，77%）的冠心病和 62%（95%CI=42%，76%）的中风病例归因于不良的健康生活方式（包括睡眠）。将睡眠时长纳入评分后，C 统计量略有增加，从 0.64（95%CI=0.63，0.64）增加到 0.65（95%CI=0.64，0.65）（p<0.001）。
结论
在美国成年人中，采用包括睡眠建议的健康生活方式可以显著降低心血管疾病的风险。
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