Li Yan, Huang Ya-Ling, Su Hai-Rou, Wu Gui-Bing, Zhu Zhi-Xin
Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
Department of Epidemiology & Biostatistics, Center for Clinical Big Data and Statistics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
J Geriatr Cardiol. 2025 Jul 28;22(7):625-637. doi: 10.26599/1671-5411.2025.07.008.
It remains unclear whether sleep duration and physical activity (PA) trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases (CVDs). This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.
This study was based on the China Health and Retirement Longitudinal Study. 12009 adults aged 45 years and older from five waves were included. CVD events were measured by self-reports of heart disease and stroke. We first used group-based trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020, and then employed logistic regression models to analyze their risk for CVD.
We identified three sleep duration and PA trajectories. The risk of heart disease increased by 33% (OR = 1.31, 95% CI: 1.12-1.53) for the short sleep duration trajectory ( moderate sleep duration trajectory), by 40% (OR = 1.40, 95% CI: 1.06-1.84) for the high decreasing PA trajectory, and by 20% (OR = 1.20, 95% CI: 1.01-1.42) for the low stable PA trajectory ( high stable PA trajectory), respectively. Similar results for stroke and CVD as the outcomes were also observed, but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant. The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.
Short total sleep duration, high decreasing PA, and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults. Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.
目前尚不清楚中老年人群的睡眠时间和身体活动（PA）轨迹是否与心血管疾病（CVD）的不同风险相关。本研究旨在探讨中国中老年成年人的总睡眠时间和PA轨迹及其对CVD风险的影响。
本研究基于中国健康与养老追踪调查。纳入了来自五轮调查的12009名45岁及以上的成年人。通过心脏病和中风的自我报告来衡量CVD事件。我们首先使用基于群体的轨迹模型来识别2011年至2020年的总睡眠时间和PA轨迹，然后采用逻辑回归模型分析它们患CVD的风险。
我们识别出三种睡眠时间和PA轨迹。短睡眠时间轨迹（中等睡眠时间轨迹）患心脏病的风险增加33%（OR = 1.31，95%CI：1.12 - 1.53），高下降PA轨迹患心脏病的风险增加40%（OR = 1.40，95%CI：1.06 - 1.84），低稳定PA轨迹（高稳定PA轨迹）患心脏病的风险增加20%（OR = 1.20，95%CI：1.01 - 1.42）。以中风和CVD作为结局也观察到了类似结果，但高下降PA轨迹组中风风险较高这一情况无统计学意义。与短睡眠时间和低稳定PA轨迹相比，睡眠时间适中或较长且PA高稳定的轨迹中，睡眠和PA的联合效应显示心脏病和中风风险较低。
总睡眠时间短、PA高下降和PA低稳定轨迹可能会增加中老年成年人患CVD的风险。长期总睡眠时间适中至较长且PA高稳定轨迹可能对预防CVD最为有利。
