Influence of physical activity on mortality in elderly with coronary artery disease
Influence of physical activity on mortality in elderly with coronary artery disease
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DOI：
10.1249/01.mss.0000191185.58467.be
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发表时间：
2006-03-01
影响因子：
4.1
通讯作者：
Jolliffe, CJ
中科院分区：
文献类型：
--
作者：
Janssen, I;Jolliffe, CJ
目的：主要目标是1）检查CAD患者身体活动与死亡率之间的剂量-反应关系，以及2）确定上述关系在其他个人特征分层中是否一致。方法：受试者包括1045名来自心血管健康研究的老年男性和女性CAD患者。在第一组分析中，使用考克斯比例风险回归模型确定基线闲暇时间体力活动水平与9年以上全因死亡风险之间的剂量反应关系。接下来，根据几个不同的特征对受试者进行分层，并确定各分层中基线闲暇时间体力活动与死亡风险之间关系的一致性。结果如下：基线休闲时间体力活动与全因死亡风险以曲线密切反应方式相关，在能量消耗量表的低端可以看到死亡风险的较大差异，在大约4000 kcal时出现平台期。wk（-1）。在性别、年龄、吸烟、肥胖、自我感觉健康状况、共病数量和CAD类型的不同分层中，积极参与者的死亡率相对风险较低（>= 1500 kcal（.）wk（-1））与不活动参与者（< 1500 kcal（.）wk（-1））。结论：这项研究强调了身体活动与CAD男性和女性全因死亡率之间的反比关系。无论受试者是男性还是女性，老年人还是非常老年人，吸烟者还是不吸烟者，瘦还是超重，健康还是不健康，缺乏身体活动都是死亡的危险因素。
Purpose: The primary objectives were to 1) examine the dose-response relationship between physical activity and mortality in individuals with CAD, and 2) determine whether the aforementioned relationship is consistent within strata of other personal characteristics. Methods: Subjects included 1045 elderly men and women with CAD from the Cardiovascular Health Study. In the first set of analyses, the dose-response relationship between baseline leisure-time physical activity level and all-cause mortality risk over 9 yr was determined using Cox proportional hazards regression models. Next, the subjects were stratified based on several different characteristics, and the consistency of the relationship between baseline leisure-time physical activity and mortality risk within the various strata was determined. Results: Baseline leisure-time physical activity was related to all-cause mortality risk in a curvilinear close-response manner such that greater differences in mortality risk were seen at the lower end of the energy expenditure scale, with a plateau occurring at approximately 4000 kcal(.)wk(-1). Within various strata of sex, age, smoking, adiposity, self-perceived health status, number of comorbid conditions, and type of CAD; the relative risks of mortality were lower in active participants (>= 1500 kcal(.)wk(-1)) in comparison with inactive participants (< 1500 kcal(.)wk(-1)). Conclusion: This study highlights the inverse graded relationship between physical activity and all-cause mortality in men and women with CAD. Physical inactivity was a risk factor for mortality regardless of whether the subjects were men or women, old or very old, smokers or nonsmokers, lean or overweight, or otherwise healthy or unhealthy.