Body mass index and vigorous physical activity and the risk of heart failure among men.
Body mass index and vigorous physical activity and the risk of heart failure among men.
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DOI：
10.1161/circulationaha.108.807289
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发表时间：
2009-01-06
期刊：
影响因子：
37.8
通讯作者：
Gaziano JM
中科院分区：
文献类型：
--
作者：
Kenchaiah S;Sesso HD;Gaziano JM
肥胖范围内（≥30）的体重指数（BMI，体重（千克）/身高（米2））升高与心力衰竭（HF）的过度风险相关。然而，超重或肥胖前期（BMI 25至29.9）状态和体力活动对HF风险的影响尚不清楚。在医生健康研究的一项前瞻性队列研究中，21，094名男性（平均年龄53岁）在基线时没有已知的冠心病，我们检查了1982年至2007年BMI和剧烈体力活动（运动到出汗）对HF发病率的个体和综合影响。我们将BMI作为连续变量（每增加1 kg/m2）和分类变量（瘦，<25，超重，25至29.9，肥胖，≥30）进行评估，并将剧烈体力活动主要作为二分变量（不活动[很少/从不] vs.活动[每月≥1至3次]）进行评估。在随访期间（平均20.5年），1109名参与者出现新发心力衰竭。在多变量分析中，BMI每增加1 kg/m2与HF风险增加11%（95%CI 9 - 13%）相关。与瘦型参与者相比，超重参与者HF风险增加49%（95%CI 32 - 69%），肥胖参与者HF风险增加180%（95%CI 124 - 250%）。剧烈的体力活动可使HF风险降低18%（95%CI 4 - 30%）。BMI和剧烈体力活动与HF风险之间没有相互作用（p=0.96）。精瘦-活跃的男性患HF的风险最低，肥胖-不活跃的男性患HF的风险最高。与精瘦-活动型男性相比，风险比（95%CI）为1.19（0.94至1.51）、1.49（1.30至1.71）、1.78（1.43至2.23）、2.68瘦-不活动、超重-活动、超重-不活动、肥胖-活动和肥胖-不活动组分别为2.08 ~ 3.45和3.93（2.60 ~ 5.96）。在这个男性队列中，BMI升高，即使在肥胖前期范围内，也与HF风险增加相关，剧烈的体力活动与风险降低相关。公共卫生措施，以减少多余的体重，保持最佳体重，并促进体力活动可能会限制HF的祸害。
Elevated body-mass index (BMI, weight in kilograms/height in meters2), in the obese range (≥30) is associated with an excess risk of heart failure (HF). However, impact of overweight or preobese (BMI 25 to 29.9) status and physical activity to HF risk is unclear. In a prospective cohort of 21,094 men (mean age, 53 years) without known coronary heart disease at baseline in the Physicians’ Health Study, we examined the individual and combined effects of BMI and vigorous physical activity (exercise to the point of breaking a sweat) to HF incidence from 1982 to 2007. We evaluated BMI as both a continuous (per 1 kg/m2 increment) and a categorical (lean, <25, overweight, 25 to 29.9, and obese, ≥30) variable, and vigorous physical activity primarily as a dichotomous variable (inactive [rarely/never] vs. active [≥1 to 3 times a month]). During follow-up (mean 20.5 years), 1109 participants developed new-onset HF. In multivariable analyses, every 1 kg/m2 increase in BMI was associated with an 11% (95%CI 9 to 13%) increase in HF risk. Compared with lean participants, overweight participants had a 49% (95%CI 32 to 69%) and obese participants had a 180% (95%CI 124 to 250%) increase in HF risk. Vigorous physical activity conferred an 18% (95%CI 4 to 30%) decrease in HF risk. No interaction was found between BMI and vigorous physical activity to HF risk (p=0.96). Lean-active men had the lowest and obese-inactive men had the highest risk of HF. Compared with lean-active men, the hazard ratios (95%CI) were 1.19 (0.94 to 1.51), 1.49 (1.30 to 1.71), 1.78 (1.43 to 2.23), 2.68 (2.08 to 3.45), and 3.93 (2.60 to 5.96) in lean-inactive, overweight-active, overweight-inactive, obese-active, and obese-inactive men respectively. In this cohort of men, elevated BMI, even in preobese range, was associated with an increased risk of HF and vigorous physical activity was associated with a decreased risk. Public health measures to curtail excess weight, maintain optimal weight, and promote physical activity may limit the scourge of HF.