Contribution of Major Lifestyle Risk Factors for Incident Heart Failure in Older Adults The Cardiovascular Health Study
Contribution of Major Lifestyle Risk Factors for Incident Heart Failure in Older Adults The Cardiovascular Health Study
复制标题
DOI：
10.1016/j.jchf.2015.02.009
复制
发表时间：
2015-07-01
影响因子：
13
通讯作者：
Mozaffarian, Dariush
中科院分区：
文献类型：
--
作者：
Del Gobbo, Liana C.;Kalantarian, Shadi;Mozaffarian, Dariush
本研究的目的是确定主要生活方式因素对老年人心力衰竭（HF）发展的相对影响。背景HF在≥ 65岁的成年人中引起高发病率、死亡率和卫生保健费用，这是美国人口中增长最快的部分。方法我们前瞻性地调查了生活方式危险因素与在心血管健康研究中，4,490名男性和女性在21.5年内发生HF（1,380例），这是一项基于社区的老年人队列研究。生活方式因素包括4种饮食模式（替代健康饮食指数，阻止高血压的饮食方法，美国心脏协会2020年饮食目标评分，以及使用先前对心血管疾病饮食风险因素的了解构建的生物模式），4项身体活动指标（运动强度、步行速度、休闲活动消耗的能量和步行距离）、酒精摄入、吸烟、结果无饮食模式与HF的发生有关（p > 0.05）。步行速度和休闲活动分别与HF风险降低26%和22%相关（步速> 3 mph vs. < 2 mph;风险比[HR]：0.74; 95%置信区间[CI]：0.63 - 0.86;休闲活动>= 845 kcal/周vs. < 845 kcal/周; HR：0.78; 95% CI：0.69至0.87）。适度饮酒、保持体重指数< 30 kg/m2和不吸烟也与HF风险降低独立相关。健康生活方式因素>= 4的参与者发生HF的风险降低45%（HR：0.55; 95%CI：0.42 - 0.74）。年龄，性别，心血管疾病，高血压药物的使用，和糖尿病没有observed.CONCLUSIONS在美国老年人，体力活动，适度饮酒，避免肥胖，不吸烟，但不是饮食模式，与HF的风险较低。(C)2015年由美国心脏病学会基金会。
OBJECTIVES The goal of this study was to determine the relative contribution of major lifestyle factors on the development of heart failure (HF) in older adults.BACKGROUND HF incurs high morbidity, mortality, and health care costs among adults >= 65 years of age, which is the most rapidly growing segment of the U.S. population.METHODS We prospectively investigated separate and combined associations of lifestyle risk factors with incident HF (1,380 cases) over 21.5 years among 4,490 men and women in the Cardiovascular Health Study, which is a community-based cohort of older adults. Lifestyle factors included 4 dietary patterns (Alternative Healthy Eating Index, Dietary Approaches to Stop Hypertension, an American Heart Association 2020 dietary goals score, and a Biologic pattern, which was constructed using previous knowledge of cardiovascular disease dietary risk factors), 4 physical activity metrics (exercise intensity, walking pace, energy expended in leisure activity, and walking distance), alcohol intake, smoking, and obesity.RESULTS No dietary pattern was associated with developing HF (p > 0.05). Walking pace and leisure activity were associated with a 26% and 22% lower risk of HF, respectively (pace > 3 mph vs. < 2 mph; hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.63 to 0.86; leisure activity >= 845 kcal/week vs. < 845 kcal/week; HR: 0.78; 95% CI: 0.69 to 0.87). Modest alcohol intake, maintaining a body mass index < 30 kg/m(2), and not smoking were also independently associated with a lower risk of HF. Participants with >= 4 healthy lifestyle factors had a 45% (HR: 0.55; 95% CI: 0.42 to 0.74) lower risk of HF. Heterogeneity by age, sex, cardiovascular disease, hypertension medication use, and diabetes was not observed.CONCLUSIONS Among older U.S. adults, physical activity, modest alcohol intake, avoiding obesity, and not smoking, but not dietary patterns, were associated with a lower risk of HF. (C) 2015 by the American College of Cardiology Foundation.