Division of Cardiology, Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts.
Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Am J Cardiol. 2022 Oct 15;181:32-37. doi: 10.1016/j.amjcard.2022.07.010. Epub 2022 Aug 18.
Current guidelines encourage regular physical activity (PA) to gain cardiovascular health benefit. However, little is known about whether older adults with atrial fibrillation (AF) who engage in the guideline-recommended level of PA are less likely to experience clinically relevant outcomes. We did a retrospective study based on the data from Systemic Assessment of Geriatric Elements in AF (SAGE-AF) prospective cohort study. The study population consisted of older participants with AF (≥65 years) and a congestive heart failure, hypertension, age, diabetes, stroke vascular disease, age 65 to 75 and sex(CHADS-VASc) score ≥2. PA was quantified by self-reported Minnesota Leisure Time PA questionnaire. Competing risk models were used to examine the association between PA level and clinical outcomes over 2 years while controlling for several potentially confounding variables. A total of 1,244 participants (average age 76 years; 51% men; 85% non-Hispanic White) were studied. A total of 50.5% of participants engaged in regular PA. Meeting the recommended level of PA was associated with lower mortality over 2 years (adjusted hazard ratio 0.60, 95% confidence interval 0.38 to 0.95) but was not associated with rates of stroke or major bleeding. In conclusion, older adults with AF who engaged in guideline-recommended PA are more likely to survive in the long term. Healthcare providers should promote and encourage engagement in PA and tailor interventions to address barriers of engagement.
目前的指南鼓励老年人进行有规律的身体活动(PA),以获得心血管健康益处。然而,对于进行指南推荐水平的 PA 的患有心房颤动(AF)的老年人是否不太可能经历临床相关结局,知之甚少。我们基于系统性评估老年心房颤动因素(SAGE-AF)前瞻性队列研究的数据进行了一项回顾性研究。研究人群包括患有 AF(≥65 岁)和充血性心力衰竭、高血压、年龄、糖尿病、中风血管疾病、年龄 65 至 75 岁和性别(CHADS-VASc)评分≥2 的老年参与者。PA 通过自我报告的明尼苏达州休闲时间 PA 问卷进行量化。使用竞争风险模型来检查 PA 水平与 2 年内临床结局之间的关联,同时控制了几个潜在的混杂变量。共有 1244 名参与者(平均年龄 76 岁;51%为男性;85%为非西班牙裔白人)接受了研究。共有 50.5%的参与者进行了有规律的 PA。在 2 年内,达到推荐的 PA 水平与死亡率降低相关(调整后的危险比 0.60,95%置信区间 0.38 至 0.95),但与中风或大出血发生率无关。总之,进行指南推荐的 PA 的患有 AF 的老年人在长期内更有可能存活。医疗保健提供者应促进和鼓励参与 PA,并针对参与障碍进行干预。