Institute of Health and Wellbeing (F.K.H., Z.Z., F.P.-R., S.P.-S., J.P.P.), University of Glasgow, United Kingdom.
Institute of Cardiovascular & Medical Sciences (F.P.-R., S.P.-S., J.B., P.W., J.M.R.G., S.R.G., N.S., C.C.-M.), University of Glasgow, United Kingdom.
Circulation. 2022 Sep 20;146(12):883-891. doi: 10.1161/CIRCULATIONAHA.122.059663. Epub 2022 Aug 29.
Studies of objectively measured physical activity (PA) have investigated acute cardiovascular outcomes but not heart failure (HF), an emerging chronic condition. This study aimed to investigate the dose-response relationship between device-measured PA and HF by intensity of PA.
This was a prospective cohort study of 94 739 UK Biobank participants who had device-measured PA in 2013 to 2015 and were free from myocardial infarction and HF. PA was measured with a wrist-worn accelerometer, and time spent on light-, moderate-, and vigorous-intensity PA was extracted. Incident HF was ascertained from linked hospital and death records. Cox proportional hazard models with cubic penalized splines were used to study the associations, which were adjusted for sociodemographic and lifestyle factors. Competing risk was handled with cause-specific hazard ratios.
The overall incidence of HF was 98.5 per 10 000 person-years over a median 6.1 years of follow-up. Compared with participants who undertook no moderate- to vigorous-intensity PA, those who performed 150 to 300 min/wk of moderate-intensity PA (hazard ratio, 0.37 [95% CI, 0.34-0.41]) and 75 to 150 min/wk of vigorous-intensity PA (hazard ratio, 0.34 [95% CI, 0.25-0.46]) were at lower HF risk. The association between vigorous-intensity PA and HF was reverse-J shaped with a potentially lower risk reduction above 150 min/wk.
Device-measured PA, especially moderate-intensity PA, was associated with a lower risk of HF. Current vigorous-intensity PA recommendations should be encouraged but not increased. In contrast, increasing moderate-intensity PA may be beneficial even among those meeting current recommendations.
客观测量的身体活动（PA）研究已经调查了急性心血管结局，但没有心力衰竭（HF），这是一种新兴的慢性疾病。本研究旨在通过 PA 强度研究设备测量的 PA 与 HF 之间的剂量-反应关系。
这是一项前瞻性队列研究，共纳入了 94739 名英国生物库参与者，他们在 2013 年至 2015 年期间佩戴了设备测量的 PA，且没有心肌梗死和 HF。PA 是通过佩戴在手腕上的加速度计测量的，并提取出轻、中、高强度 PA 的时间。通过与医院和死亡记录的链接确定 HF 的发病情况。使用带有三次惩罚样条的 Cox 比例风险模型来研究这些关联，这些关联经过了社会人口统计学和生活方式因素的调整。使用特定于原因的风险比来处理竞争风险。
在中位随访 6.1 年期间，HF 的总体发病率为每 10000 人年 98.5 例。与没有进行中等到剧烈强度 PA 的参与者相比，那些进行 150 至 300 分钟/周的中等强度 PA（风险比，0.37 [95%CI，0.34-0.41]）和 75 至 150 分钟/周的剧烈强度 PA（风险比，0.34 [95%CI，0.25-0.46]）的 HF 风险较低。剧烈强度 PA 与 HF 之间呈反向 J 形关联，每周 150 分钟以上的潜在风险降低。
设备测量的 PA，特别是中等强度的 PA，与 HF 风险降低相关。应鼓励但不增加当前的剧烈强度 PA 建议。相反，即使在那些符合当前建议的人群中，增加中等强度的 PA 可能也是有益的。
