Hyde Eric T, Nguyen Steve, LaMonte Michael J, Di Chongzhi, Bellettiere John, Tinker Lesley F, Foraker Randi E, Tindle Hilary A, Stefanick Marcia L, LaCroix Andrea Z
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, United States.
Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, United States.
Prev Med Rep. 2024 Oct 12;47:102904. doi: 10.1016/j.pmedr.2024.102904. eCollection 2024 Nov.
The American Heart Association's Life's Essential 8 (LE8) metric includes self-reported physical activity as one of the metrics for assessing cardiovascular health. Self-reported physical activity is prone to misclassification, whereas accelerometer measures are less biased. We examined associations of LE8 and incident cardiovascular disease (CVD) using self-reported and accelerometer-measured physical activity.
Participants in the Women's Health Initiative (WHI) Objective Physical Activity and Cardiovascular Health Study (n = 4,243; mean age = 79 ± 7 years) with no CVD history completed the WHI physical activity questionnaire and the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire prior to wearing a hip-worn accelerometer for up to seven days in 2012-2014. LE8 components (physical activity, diet, sleep, body mass index, smoking, blood pressure, non-HDL cholesterol, and glucose) were scored according to guidelines. Scores were created using five physical activity measures: WHI questionnaire (LE8), CHAMPS (LE8), accelerometer-measured physical activity (LE8), and sample quantiles of accelerometer-measured physical activity (LE8) and daily steps (LE8). Hazard ratios (HR) for physician-adjudicated CVD were estimated using Cox regression.
707 incident CVD events occurred over an average 7.5 years. Multivariable HRs (95 % CI) comparing women in the highest vs. lowest quartiles of LE8 scores were: LE8 = 0.53 (0.43-0.67), LE8 = 0.47 (0.38-0.60), LE8 0.44 (0.36-0.56), LE8 = 0.44 (0.35-0.55), and LE8 = 0.45 (0.35-0.57).
The LE8-incident CVD association varies by physical activity measurement, however all methods showed reduced risk. Device-measures of physical activity may be more accurate in the LE8, but when impractical to implement, also support use of self-reported measures.
美国心脏协会的生命基本8要素（LE8）指标将自我报告的身体活动作为评估心血管健康的指标之一。自我报告的身体活动容易出现分类错误，而加速度计测量的偏差较小。我们使用自我报告和加速度计测量的身体活动来研究LE8与心血管疾病（CVD）发病之间的关联。
参加女性健康倡议（WHI）客观身体活动与心血管健康研究的参与者（n = 4,243；平均年龄 = 79 ± 7岁），无CVD病史，在2012 - 2014年佩戴髋部加速度计长达7天之前，完成了WHI身体活动问卷和老年人社区健康活动模式项目（CHAMPS）问卷。根据指南对LE8的各个组成部分（身体活动、饮食、睡眠、体重指数、吸烟、血压、非高密度脂蛋白胆固醇和血糖）进行评分。使用五种身体活动测量方法创建得分：WHI问卷（LE8）、CHAMPS（LE8）、加速度计测量的身体活动（LE8）、加速度计测量的身体活动的样本分位数（LE8）和每日步数（LE8）。使用Cox回归估计经医生判定的CVD的风险比（HR）。
在平均7.5年的时间里发生了707例CVD事件。比较LE8得分最高与最低四分位数女性的多变量HR（95%CI）分别为：LE8 = 0.53（0.43 - 0.67）、LE8 = 0.47（0.38 - 0.60）、LE8 = 0.44（0.36 - 0.56）、LE8 = 0.44（0.35 - 0.55）和LE8 = 0.45（0.35 - 0.57）。
LE8与CVD发病之间的关联因身体活动测量方法而异，但所有方法均显示风险降低。在LE8中，身体活动的设备测量可能更准确，但如果实施不切实际，也支持使用自我报告的测量方法。
