Objective Physical Activity and Cardiovascular Health in Older Women: OPACH2

尽管85岁女性发生或复发心肌梗死和致命冠心病(CHD)的比率更高 和老年(120/1000)比男性(85/1000)，以及不成比例的残疾负担和共同发病率 老年妇女与确诊和隐匿性心血管疾病(CVD)的关系，在这方面预防CVD 对弱势群体的研究严重不足。此应用程序构建在现已完成的目标之上 体力活动与心血管健康(OPACH)研究(NHLBI R01 HL105065)，辅助研究 在LaCroix博士领导的女性健康倡议长寿研究中嵌入。OPACH团队研究了 加速计测量的体力活动(PA)和久坐行为(SB)与事件CVD之间的关系 7048名年龄在63-99岁之间的女性。我们的初步结果显示，有统计学意义的，剂量反应，20% 冠心病发病率降低，心血管疾病发病率降低10%，全因死亡率降低24% 老年女性在轻度PA(1.6-2.9 Met)中每多呆一小时，患心血管疾病的风险增加12% 久坐不动每多一个小时。为了对轻型PA进行分类，OPACH团队进行了一项实验室 校准研究(200名OPACH妇女)，以确定与以下相关的绝对强度的加速度计切点 年长女性日常的私人助理习惯。PA强度的年龄分类是至关重要的，因为休息 代谢率和最大有氧能力随着年龄的增长而下降，而有氧活动的能量成本 随年龄增长。因为这些与年龄相关的变化以及它们在老年人中发生的方式的异质性 2018年PA指南证据报告敦促研究人员：“进行前瞻性队列研究 老年人的动脉压和身体功能，包括对亲属的客观测量(例如心率监测器) PA的强度。本文中的“相对”一词是指个人的最大运动能力。 OPACH2和OPACH2校准研究专门设计用于得出经过验证的加速度计- 测量PA的相对强度，并确定其与心血管事件(CHD、心力衰竭、中风)和 2027年之前的死亡率。为此，我们将获得PA和SB的第二个加速度计测量结果 无创同时测量心率(PA强度的生理测量) 心脏监测贴片(Cardea Solo)在4200-5000名存活的OPACH妇女中的应用我们还将调查交叉- 加速度计第二次磨损(2022-2023年)的相对和绝对PA强度与 潜在的心血管健康指标，包括传统的风险因素(血脂、血糖、炎症、血液 压力、肥胖)，心血管疾病病理的新生物标志物(心肌肌钙蛋白、脑利钠肽、半乳糖- 3)、心率变异性(来自Cardea Solo贴片)和体能表现。最后，我们将确定 加速度计测量的PA和SB在≈10年内的变化与传统 心血管危险因素、新的生物标记物和同一时间间隔内的身体功能 到2027年，临床心血管事件的发生率和死亡率。

Despite higher rates of incident or recurrent MI and fatal coronary heart disease (CHD) among women aged 85 and older (120/1000) than men (85/1000), and the disproportionate burden of disability and co-morbidity in aging women related to diagnosed and occult cardiovascular disease (CVD), prevention of CVD in this vulnerable population is vastly understudied. This application builds upon the now completed Objective Physical Activity and Cardiovascular Health (OPACH) Study (NHLBI R01 HL105065), ancillary study embedded in the Women’s Health Initiative Long Life Study led by Dr. LaCroix. The OPACH team studied accelerometer-measured physical activity (PA) and sedentary behavior (SB) in relation to incident CVD among 7048 women ages 63-99. Our primary results showed a statistically significant, dose responsive, 20% reduction in incident CHD, a 10% reduction in incident CVD, and a 24% reduction in all-cause mortality for every additional hour spent in light PA (1.6-2.9 METs) in older women; and a 12% increased risk of CVD for every additional hour spent sedentary. To classify light PA, the OPACH team conducted a laboratory calibration study (200 OPACH women) to determine accelerometer cutpoints for absolute intensity relevant to the usual daily PA habits of older women. Age-specific classification of PA intensity is critical because resting metabolic rate and maximal aerobic capacity decline with aging, whereas the energy cost of aerobic activity increases with age. Because of these age-related changes and the heterogeneity in how they occur in older adults, the 2018 PA Guidelines Evidence Report urged researchers to: “Conduct prospective cohort studies of PA and physical function in older adults that include objective measures (e.g., heart rate monitors) of relative intensity of PA.” The term “relative” in this context refers to the maximal exercise capacity of individuals. OPACH2 and the OPACH2 Calibration Study are designed specifically to derive validated accelerometer- measured PA relative intensity and determine its association with incident CVD (CHD, heart failure, stroke) and mortality through 2027. To do this, we will obtain a second accelerometer measurement of PA and SB with contemporaneous measurement of heart rate (a physiological measure of PA intensity) using a non-invasive cardiac monitor patch (Cardea SOLO) in 4200-5000 surviving OPACH women. We will also investigate cross- sectional associations at the second accelerometer wear (2022-2023) of relative and absolute PA intensity with indicators of underlying CV health including traditional risk factors (lipids, glycemia, inflammation, blood pressure, adiposity), novel biomarkers of CVD pathology (cardiac troponin, brain natriuretic peptide, galactin- 3), heart rate variability (from Cardea SOLO patch), and physical performance. Finally, we will determine the association of changes in accelerometer-measured PA and SB over ≈10 years with changes in traditional cardiovascular risk factors, novel biomarkers, and physical functioning during the same interval, and with incidence of clinical CVD events and mortality through 2027.