Exercise capacity and the risk of death in women - The St James Women Take Heart Project
Exercise capacity and the risk of death in women - The St James Women Take Heart Project
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DOI：
10.1161/01.cir.0000091080.57509.e9
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发表时间：
2003-09-30
期刊：
影响因子：
37.8
通讯作者：
Black, HR
中科院分区：
文献类型：
--
作者：
Gulati, M;Pandey, DK;Black, HR
背景——心血管疾病是女性死亡的主要原因，占女性死亡人数的一半以上。在大多数心血管疾病研究中，女性的代表性不足。身体素质下降已被证明会增加男性的死亡风险。运动负荷测试测量的运动能力是身体素质的客观衡量标准。运动能力下降与死亡风险增加相关的假设是在 1992 年接受基线检查的 5721 名无症状女性队列中进行的。方法和结果 - 使用 Bruce 方案收集的基线信息包括病史和家族史、人口特征、体格检查和症状限制应激心电图。运动能力以代谢当量（MET）来衡量。在基线时分析非空腹血液。进行了全国死亡指数搜索，以确定截至 2000 年底的全因死亡和死亡日期。基线时参与者的平均年龄为 52 +/- 11 岁。弗雷明汉风险评分 - 与 MET 水平为 8 相关的死亡调整后风险比（95% CI）分别为 3.1（2.0 至 4.7）、1.9（1.3 至 2.9）和 1.00。弗雷明汉风险评分 - 每增加 1-MET，调整后的死亡风险就会降低 17%。结论 - 这是在最长的随访期间在此背景下研究的最大的无症状女性队列。这项研究证实，运动能力是无症状女性死亡的独立预测因素，高于之前在男性中确定的预测因素。对临床实践和医疗保健政策的影响是深远的。
Background - Cardiovascular disease is the leading cause of death among women and accounts for more than half of their deaths. Women have been underrepresented in most studies of cardiovascular disease. Reduced physical fitness has been shown to increase the risk of death in men. Exercise capacity measured by exercise stress test is an objective measure of physical fitness. The hypothesis that reduced exercise capacity is associated with an increased risk of death was investigated in a cohort of 5721 asymptomatic women who underwent baseline examinations in 1992.Methods and Results - Information collected at baseline included medical and family history, demographic characteristics, physical examination, and symptom-limited stress ECG, using the Bruce protocol. Exercise capacity was measured in metabolic equivalents (MET). Nonfasting blood was analyzed at baseline. A National Death Index search was performed to identify all-cause death and date of death up to the end of 2000. The mean age of participants at baseline was 52 +/- 11 years. Framingham Risk Score - adjusted hazards ratios ( with 95% CI) of death associated with MET levels of 8 were 3.1 (2.0 to 4.7), 1.9 (1.3 to 2.9), and 1.00, respectively. The Framingham Risk Score - adjusted mortality risk decreased by 17% for every 1-MET increase.Conclusions - This is the largest cohort of asymptomatic women studied in this context over the longest period of follow-up. This study confirms that exercise capacity is an independent predictor of death in asymptomatic women, greater than what has been previously established among men. The implications for clinical practice and health care policy are far reaching.