Association of Sedentary Time and Incident Heart Failure Hospitalization in Postmenopausal Women.
Association of Sedentary Time and Incident Heart Failure Hospitalization in Postmenopausal Women.
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DOI：
10.1161/circheartfailure.120.007508
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发表时间：
2020-12
期刊：
影响因子：
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通讯作者：
Eaton CB
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作者：
LaMonte MJ;Larson JC;Manson JE;Bellettiere J;Lewis CE;LaCroix AZ;Bea JW;Johnson KC;Klein L;Noel CA;Stefanick ML;Wactawski-Wende J;Eaton CB
2018年美国身体活动指南建议减少久坐行为（SB）以促进心血管健康。SB在心力衰竭（HF）中的作用尚不清楚。我们在妇女健康倡议观察性研究中研究了80，982名年龄在50-79岁之间的妇女，她们没有已知的HF，并且在基线时报告了独立行走≥1个街区的能力。对于医生裁定的HF住院事件（1，402例病例），平均随访时间为9年。SB通过问卷反复评估。根据坐着或躺着的清醒时间（≤6.5、6.6-9.5、>9.5小时/天）对时变总SB进行分类;还评价了坐着时间（≤4.5、4.6-8.5、>8.5小时/天）。使用考克斯回归估计风险比（HR）和95%置信区间（CI）。控制年龄、种族、教育、收入、吸烟、饮酒、绝经期激素治疗和子宫切除术状态，在随时间变化的总SB的增量三分位数中观察到较高的HF风险。（风险比[95%置信区间]：1.00 [参考]，1.15 [1.01，1.31]，1.42 [1.25，1.61]，趋势p<.001）和坐位时间（1.00 [参考]，1.14 [1.01，1.28]，1.54 [1.34，1.78]，趋势p<.001）。在进一步控制包括时变心肌梗死和冠状动脉血运重建在内的合并症后，（HR：SB 1.00，1.11，1.27;坐位1.00，1.09，1.37，趋势p<.001），以及基线体力活动（HR：SB 1.00、1.10、1.24;坐位1.00、1.08、1.33，趋势p<0.001）。根据基线年龄、种族-民族、BMI、体力活动、身体功能、糖尿病、高血压或CHD的类别，与SB暴露的相关性没有差异。SB与绝经后妇女HF住院风险增加相关。有针对性的努力，以减少SB可以提高HF预防在以后的生活。
The 2018 U.S. Physical Activity Guidelines recommend reducing sedentary behavior (SB) for cardiovascular health. SB’s role in heart failure (HF) is unclear. We studied 80,982 women in the Women’s Health Initiative Observational Study, aged 50–79, who were without known HF and reported ability to walk ≥1 block unassisted at baseline. Mean follow-up was 9 years for physician-adjudicated incident HF hospitalization (1,402 cases). SB was assessed repeatedly by questionnaire. Time-varying total SB was categorized according to awake time spent sitting or lying down (≤6.5, 6.6–9.5, >9.5 hr/day); sitting time (≤4.5, 4.6–8.5, >8.5 hr/day) was also evaluated. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. Controlling for age, race-ethnicity, education, income, smoking, alcohol, menopausal hormone therapy, and hysterectomy status, higher HF risk was observed across incremental tertiles of time-varying total SB (HR [95% CI]: 1.00 [referent], 1.15 [1.01, 1.31], 1.42 [1.25, 1.61], trend p<.001) and sitting time (1.00 [referent], 1.14 [1.01, 1.28], 1.54 [1.34, 1.78], trend p<.001). The inverse trends remained significant after further controlling for comorbidities including time-varying myocardial infarction and coronary revascularization (HRs: SB 1.00, 1.11, 1.27; sitting 1.00, 1.09, 1.37, trend p<.001 each), and for baseline physical activity (HRs: SB 1.00, 1.10, 1.24; sitting 1.00, 1.08, 1.33, trend p<.001 each). Associations with SB exposures were not different according to categories of baseline age, race-ethnicity, BMI, physical activity, physical functioning, diabetes, hypertension or CHD. SB was associated with increased risk of incident HF hospitalization in postmenopausal women. Targeted efforts to reduce SB could enhance HF prevention in later life.