Association between physical activity and peripheral artery disease and carotid artery stenosis in a self-referred population of 3 million adults.
Association between physical activity and peripheral artery disease and carotid artery stenosis in a self-referred population of 3 million adults.
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DOI：
10.1161/atvbaha.114.304161
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Berger JS
中科院分区：
文献类型：
--
作者：
Stein RA;Rockman CB;Guo Y;Adelman MA;Riles T;Hiatt WR;Berger JS
虽然体力活动和冠心病之间的关系已经得到了很好的表征，但关于体力活动和其他动脉区域血管疾病的数据却很少。本研究调查了与体力活动相关的外周动脉疾病（PAD）和颈动脉狭窄（CAS）的患病率。从2003年到2008年，在美国超过300万自我推荐的美国参与者中检查了身体活动和血管疾病之间的关联，这些参与者在生命线筛查计划中完成了医疗和生活方式问卷。所有受试者均通过50%的踝臂指数进行评估<0.90 for PAD and ultrasound imaging for CAS >。多变量逻辑回归模型用于估计疾病的几率。在3，250，350名受试者中，63%的人在休闲时间进行了一些剧烈的体育活动。校正年龄、性别、人种/种族、高血压、高胆固醇血症、吸烟状况、糖尿病、体重指数和心血管疾病家族史后，报告任何体力活动的受试者发生PAD（OR 0.64，95% CI 0.63 - 0.65）和CAS（OR 0.80，95% CI 0.79 - 0.81）的几率显著降低。当按性别、种族和年龄类别分层时，体力活动与PAD和CAS之间的关联是稳健的。体力活动强度频率以分级方式与较低的PAD和CAS相关（两者的p趋势均<0.0001）。结果似乎不受合并症或适应症混杂因素的影响。在一项基于大规模人群的研究中，较高水平的体力活动与下肢和颈动脉血管疾病的风险较低独立相关。
While the relationship between physical activity and coronary heart disease is well characterized, a paucity of data exists regarding physical activity and vascular disease in other arterial territories. This study examined the prevalence of peripheral artery disease (PAD) and carotid artery stenosis (CAS) in association with physical activity. The association between physical activity and vascular disease was examined in more than 3 million self-referred US participants in the United States from 2003–2008 who completed a medical and lifestyle questionnaire in the Life Line screening program. All subjects were evaluated by screening ankle brachial indices <0.90 for PAD and ultrasound imaging for CAS >50%. Multivariable logistic regression modeling was used to estimate odds of disease. Among 3,250,350 subjects, 63% of the population engaged in some leisure time vigorous physical activity. After adjustment for age, sex, race/ethnicity, hypertension, hypercholesterolemia, smoking status, diabetes, body mass index and family history of cardiovascular disease, subjects who reported any physical activity had a significantly lower odds of PAD (OR 0.64, 95% CI 0.63 – 0.65) and CAS (OR 0.80, 95% CI 0.79 – 0.81). The association between physical activity with PAD and CAS was robust when stratified by sex, race and age categories. Physical activity intensity frequency was associated with lower PAD and CAS in a graded manner (p trend <0.0001 for both). Findings appeared unaffected by confounding by comorbidity or indication. In a large population based study, higher levels of physical activity were independently associated with lower odds of vascular disease in the lower extremities and carotid arteries.