Trajectories in Leisure-Time Physical Activity and Risk of Stroke in Women in the California Teachers Study.
Trajectories in Leisure-Time Physical Activity and Risk of Stroke in Women in the California Teachers Study.
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在加利福尼亚教师研究中，在休闲时间体育锻炼的轨迹和女性中风的风险。
DOI：
10.1161/strokeaha.117.017465
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发表时间：
2017-09
期刊：
影响因子：
8.3
通讯作者：
Wang SS
中科院分区：
文献类型：
--
作者：
Willey JZ;Voutsinas J;Sherzai A;Ma H;Bernstein L;Elkind MSV;Cheung YK;Wang SS
休闲时间体力活动 (LTPA) 随着时间的推移而发生的变化是否与降低中风风险相关尚不明确。我们在加州教师研究 (CTS) 中研究了自我报告的 LTPA 变化与中风风险之间的关联（相隔 10 年）。我们假设那些保持活跃的人中风的风险最低。 61,256 名 CTS 参与者在两个时间点（基线 1995-96 年；10 年随访 2005-2006 年）报告了两种强度水平（中等和剧烈活动）的 LTPA。每个强度级别的 LTPA 根据美国心脏协会 (AHA) 的建议进行分类（中度 > 150 分钟/周，剧烈 > 75 分钟/周）。 LTPA 的变化总结如下： (i) 在两个时间点均未达到建议； (ii) 仅在后续行动中满足建议； (iii) 仅在基线上满足建议； (iv) 在两个时间点均满足建议。中风事件是通过加州住院记录确定的。使用多变量 Cox 模型，我们研究了 LTPA 变化与中风发生率之间的关联。 987 名被诊断患有中风的女性完成了这两项调查问卷。在两个时间点均满足 AHA 建议与降低所有卒中风险相关（调整后 HR 0.84，95%CI0.72-0.98）。对中风的保护作用是通过满足 AHA 对中等活动的建议来驱动的，并且在很大程度上观察到了对缺血性中风的影响（调整后的 HR 0.70，95%CI 0.55-0.88）。满足美国心脏协会关于适度活动的建议对于降低缺血性中风风险具有保护作用。然而，在基线时满足 AHA 建议但在随访时未达到建议的参与者并没有降低中风风险。
Whether changes in leisure-time physical activity (LTPA) over time are associated with lower risk of stroke is not well established. We examined the association between changes in self-reported LTPA 10 years apart, with risk of incident stroke in the California Teachers Study (CTS). We hypothesized that the risk of stroke would be lowest among those who remained active. 61,256 CTS participants reported LTPA at two intensity levels (moderate and strenuous activity) at two time points (baseline 1995-96; 10-year follow-up 2005-2006). LTPA at each intensity level was categorized based on American Heart Association (AHA) recommendations (moderate >150 minutes/week, strenuous >75 minutes/week). Changes in LTPA were summarized as follows: (i)not meeting recommendations at both time points; (ii)meeting recommendations only at follow-up; (iii)meeting recommendations only at baseline; (iv)meeting recommendations at both time points. Incident strokes were identified through California state hospitalization records. Using multi-variable Cox models, we examined the associations between changes in LTPA with incident stroke. 987 women were diagnosed with stroke who completed both questionnaires. Meeting AHA recommendations at both time-points was associated with a lower risk of all stroke (adjusted HR 0.84, 95%CI0.72-0.98). The protective effects for stroke were driven by meeting AHA recommendations for moderate activity and largely observed for ischemic strokes (adjusted HR 0.70, 95%CI 0.55-0.88). Meeting AHA recommendations for moderate activity had a protective effect for reducing ischemic stroke risk. Participants who met AHA recommendations at baseline but not at follow-up, however, were not afforded reduced stroke risk.