Physical Activity, Sedentary Behavior, and Long-Term Changes in Aortic Stiffness: The Whitehall II Study.
Physical Activity, Sedentary Behavior, and Long-Term Changes in Aortic Stiffness: The Whitehall II Study.
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DOI：
10.1161/jaha.117.005974
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发表时间：
2017-08-07
影响因子：
5.4
通讯作者：
Brunner EJ
中科院分区：
文献类型：
--
作者：
Ahmadi-Abhari S;Sabia S;Shipley MJ;Kivimäki M;Singh-Manoux A;Tabak A;McEniery C;Wilkinson IB;Brunner EJ
体力活动与降低心血管疾病风险有关，主要是通过影响动脉粥样硬化。主动脉僵硬可能是一种替代机制。我们研究了体力活动和久坐行为模式是否与主动脉硬化率相关。在Whitehall‐II研究（N=5196）中，在平均年龄65岁（2008/2009年）和70岁（2012/2013年）时，使用压平眼压测量法测量了两次颈动脉-股动脉脉搏波速度（PWV）。在PWV基线（2008/2009）和之前两次（1997/1999和2002/2003）自我报告体力活动。久坐时间定义为坐着看电视或工作/通勤的时间。线性混合模型调整代谢和生活方式的危险因素被用来分析PWV的变化。基线时平均（SD）PWV（m/s）为8.4（2.4），随访时为9.2（2.7），5年时增加0.76 m/s（95% CI 0.69，0.83）。每周每增加一小时的体育活动（-0.02 m/s [95% CI-0.03，-0.001]）或骑自行车（-0.02 m/s [-0.03，-0.008]），PWV的5年增幅较小。散步、做家务、园艺或自己动手的活动与主动脉硬化无显著相关性。在针对体力活动调整的模型中，每增加一小时/周的坐姿与PWV进展加快相关（0.007 m/s [95% CI 0.001，0.013]）。与不改变活动水平相比，随着时间的推移增加体力活动与PWV的后续增加较小相关（-0.16 m/s [-0.32，-0.002]）。较高水平的中度至剧烈体力活动和避免久坐行为均与年龄相关的主动脉僵硬进展较慢相关，与传统血管风险因素无关。
Physical activity is associated with reduced cardiovascular disease risk, mainly through effects on atherosclerosis. Aortic stiffness may be an alternative mechanism. We examined whether patterns of physical activity and sedentary behavior are associated with rate of aortic stiffening. Carotid–femoral pulse wave velocity (PWV) was measured twice using applanation tonometry at mean ages 65 (in 2008/2009) and 70 (in 2012/2013) years in the Whitehall‐II study (N=5196). Physical activity was self‐reported at PWV baseline (2008/2009) and twice before (in 1997/1999 and 2002/2003). Sedentary time was defined as sitting time watching television or at work/commute. Linear mixed models adjusted for metabolic and lifestyle risk factors were used to analyze PWV change. Mean (SD) PWV (m/s) was 8.4 (2.4) at baseline and 9.2 (2.7) at follow‐up, representing a 5‐year increase of 0.76 m/s (95% CI 0.69, 0.83). A smaller 5‐year increase in PWV was observed for each additional hour/week spent in sports activity (−0.02 m/s [95% CI −0.03, −0.001]) or cycling (−0.02 m/s [−0.03, −0.008]). Walking, housework, gardening, or do‐it‐yourself activities were not significantly associated with aortic stiffening. Each additional hour/week spent sitting was associated with faster PWV progression in models adjusted for physical activity (0.007 m/s [95% CI 0.001, 0.013]). Increasing physical activity over time was associated with a smaller subsequent increase in PWV (−0.16 m/s [−0.32, −0.002]) compared with not changing activity levels. Higher levels of moderate‐to‐vigorous physical activity and avoidance of sedentary behavior were each associated with a slower age‐related progression of aortic stiffness independent of conventional vascular risk factors.