The short physical performance battery and incident heart failure among older women: the OPACH study.
The short physical performance battery and incident heart failure among older women: the OPACH study.
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DOI：
10.1016/j.ajpc.2021.100247
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发表时间：
2021-12
影响因子：
4.1
通讯作者：
LaMonte MJ
中科院分区：
文献类型：
--
作者：
Bellettiere J;Nguyen S;Eaton CB;Liles S;Laddu-Patel D;Di C;Stefanick ML;LaCroix AZ;LaMonte MJ
在老年女性中，较低的短期体能测试（SPPB）评分与较高的心力衰竭（HF）风险相关。SPPB-HF相关性在肥胖、糖尿病、高血压和低体力活动的女性中是一致的。将SPPB常规纳入临床评价可增强HF预防。功能能力降低是心力衰竭（HF）早期临床前阶段的标志。短期体能成套测验（SPPB）是下肢体能的有效测量方法，实施负担相对较低，与心血管疾病和死亡率相关。然而，SPPB与HF的关联在HF负担高的老年女性中研究不足。妇女（n = 5325;平均年龄79 ± 7岁; 34%的黑人、18%的西班牙裔和49%的白色）完成了SPPB，包括站立平衡、力量和行走测试，总结为从0（最低）到12（最高）的综合评分，分类为非常低（0-3）、低（4-6）、中（7-9）、或高（10-12）。对参与者进行长达8年的HF事件随访（确定了306例病例）。考克斯比例风险回归估计的风险比（HR）校正了年龄、人种/种族、教育、吸烟、饮酒、糖尿病、高血压、COPD、骨关节炎、抑郁、BMI、收缩压、血脂、葡萄糖和加速计测量的中等强度体力活动（MVPA）和久坐时间。4个SPPB类别（极低至高）中的HF事件（每1000人-年的粗发生率）分别为34例（26.0）、79例（14.5）、128例（9.3）和65例（5.6）。相应的多变量校正HR（95% CI）分别为2.22（1.34-3.66）、1.63（1.11-2.38）、1.39（1.00-1.94）和1.00（参考; P趋势<0.001）。在具有可改变的HF危险因素（包括肥胖）的女性中，较高的HF风险与较低的SPPB相关（每3单位SPPB减量的HR：存在HR = 1.41，不存在HR = 1.41），高血压（存在HR = 1.45，不存在HR = 1.30），糖尿病（当前HR = 1.32，不存在HR = 1.44），和较低的加速度计测量的MVPA（<45 min/d HR = 1.29，≥45 min/d HR = 1.60）;所有P-相互作用>0.10。即使在考虑了HF危险因素和客观测量的PA的差异后，老年女性较低的SPPB评分与较高的HF事件风险相关。在临床环境中实施SPPB可能会增强个体水平的HF风险评估，这应该进一步探索。
In older women, lower Short Physical Performance Battery (SPPB) scores were associated with higher incident heart failure (HF) risk. SPPB-HF associations were consistent in women with obesity, diabetes, hypertension, and low physical activity. Including the SPPB routinely in clinical evaluations could enhance HF prevention. Reduced functional capacity is a hallmark of early pre-clinical stages of heart failure (HF). The Short Physical Performance Battery (SPPB) is a valid measure of lower extremity physical function, has relatively low implementation burden, and is associated with cardiovascular disease and mortality. However, the SPPB-HF association is understudied in older women among whom HF burden is high. Women (n = 5325; mean age 79 ± 7 years; 34% Black, 18% Hispanic, and 49% White) without prior HF completed the SPPB consisting of standing balance, strength, and walking tests that were summarized as a composite score from 0 (lowest) to 12 (highest), categorized as very low (0–3), low (4–6), medium (7–9), or high (10–12). Participants were followed for up to 8 years for incident HF (306 cases identified). Cox proportional hazards regression estimated hazard ratios (HR) adjusting for age, race/ethnicity, education, smoking, alcohol, diabetes, hypertension, COPD, osteoarthritis, depression, BMI, systolic blood pressure, lipids, glucose, and accelerometer-measured moderate-vigorous physical activity (MVPA) and sedentary time. Incident HF cases (crude rate per 1000 person-years) in the four SPPB categories (very low to high) were 34 (26.0), 79 (14.5), 128 (9.3), and 65 (5.6). Corresponding multivariable-adjusted HRs (95% CIs) were 2.22 (1.34–3.66), 1.63 (1.11–2.38), 1.39 (1.00–1.94), and 1.00 (referent; P-trend<0.001). Higher HF risk was associated with lower SPPB in women with major modifiable HF risk factors including obesity (HR per 3-unit SPPB decrement: present HR = 1.41, absent HR = 1.41), hypertension (present HR = 1.45, absent HR = 1.30), diabetes (present HR = 1.32, absent HR = 1.44), and lower accelerometer-measured MVPA (<45 min/day HR = 1.29, ≥45 min/day HR = 1.60); all P-interaction>0.10. Lower SPPB scores were associated with greater risk of incident HF in older women even after accounting for differences in HF risk factors and objectively measured PA. Implementing the SPPB in clinical settings could potentially enhance individual-level HF risk assessment, which should be further explored.
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影响因子：
37.8
作者：
Cook NR;Paynter NP;Eaton CB;Manson JE;Martin LW;Robinson JG;Rossouw JE;Wassertheil-Smoller S;Ridker PM
通讯作者：
Ridker PM
影响因子：
37.8
作者：
Eaton, Charles B.;Abdulbaki, Abdulrahman M.;Howard, Barbara V.
通讯作者：
Howard, Barbara V.
影响因子：
3.7
作者：
Fielding, Roger A.;Guralnik, Jack M.;Rejeski, W. Jack
通讯作者：
Rejeski, W. Jack
影响因子：
5.4
作者：
Bellettiere J;Lamonte MJ;Unkart J;Liles S;Laddu-Patel D;Manson JE;Banack H;Seguin-Fowler R;Chavez P;Tinker LF;Wallace RB;LaCroix AZ
通讯作者：
LaCroix AZ
影响因子：
4.5
作者：
LaCroix AZ;Rillamas-Sun E;Buchner D;Evenson KR;Di C;Lee IM;Marshall S;LaMonte MJ;Hunt J;Tinker LF;Stefanick M;Lewis CE;Bellettiere J;Herring AH
通讯作者：
Herring AH