Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Age Ageing. 2023 Jan 8;52(1). doi: 10.1093/ageing/afac311.
longitudinal evidence concerning frailty phenotype and the risk of cardiovascular disease (CVD) remained insufficient, and whether CVD preventive strategies exert low CVD risk on frail adults is unclear.
we aimed to prospectively evaluate the association of frailty phenotype, adherence to ideal cardiovascular health (CVH) and their joint associations with the risk of CVD.
a total of 314,093 participants from the UK Biobank were included. Frailty phenotype was assessed according to the five criteria of Fried et al.: weight loss, exhaustion, low physical activity, slow gait speed and low grip strength. CVH included four core health behaviours (smoking, physical activity and diet) and three health factors (weight, cholesterol, blood pressure and glycaemic control). The outcome of interest was incident CVD, including coronary heart disease, heart failure and stroke.
compared with the non-frail people whose incident rate of overall CVD was 6.54 per 1,000 person-years, the absolute rate difference per 1,000 person-years was 1.67 (95% confidence interval, CI: 1.33, 2.02) for pre-frail and 5.00 (95% CI: 4.03, 5.97) for frail. The ideal CVH was significantly associated with a lower risk of all CVD outcomes. For the joint association of frailty and CVH level with incident CVD, the highest risk was observed among frailty accompanied by poor CVH with an HR of 2.92 (95% CI: 2.68, 3.18).
our findings indicate that physical frailty is associated with CVD incidence. Improving CVH was significantly associated with a considerable decrease in CVD risk, and such cardiovascular benefits remain for the frailty population.
关于虚弱表型与心血管疾病（CVD）风险的纵向证据仍然不足，CVD 预防策略是否能降低虚弱成年人的 CVD 风险尚不清楚。
我们旨在前瞻性评估虚弱表型、理想心血管健康（CVH）依从性及其联合与 CVD 风险的关系。
共纳入英国生物库 314093 名参与者。根据 Fried 等人的五项标准评估虚弱表型：体重减轻、疲惫、低体力活动、步态缓慢和握力低。CVH 包括四项核心健康行为（吸烟、体力活动和饮食）和三项健康因素（体重、胆固醇、血压和血糖控制）。主要终点是新发 CVD，包括冠心病、心力衰竭和中风。
与非虚弱人群（总体 CVD 的发生率为 6.54/1000 人年）相比，虚弱人群（发生率为 6.54/1000 人年）的绝对发生率差异为 1.67（95%可信区间：1.33，2.02），衰弱前期为 1.67（95%可信区间：1.33，2.02），衰弱期为 5.00（95%可信区间：4.03，5.97）。理想的 CVH 与所有 CVD 结局的低风险显著相关。对于虚弱和 CVH 水平与 CVD 事件的联合关联，在伴有较差 CVH 的虚弱患者中观察到最高风险，其 HR 为 2.92（95%可信区间：2.68，3.18）。
我们的研究结果表明，身体虚弱与 CVD 发病有关。改善 CVH 与 CVD 风险显著降低显著相关，这种心血管获益在虚弱人群中仍然存在。
