Objective Physical Activity and Cardiovascular Health in Older Women: OPACH2

老年女性的客观体力活动和心血管健康：OPACH2

• 批准号: 10682450
• 负责人: ANDREA Z. LACROIX
• 金额: $ 171.58万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10682450
• 关键词: Accelerometer; Adult; Aerobic; Aerobic Exercise; Age; Aging; American; Ancillary Study; Basal metabolic rate; Blood; Blood Pressure; Brain natriuretic peptide; Calibration; Cardiac; Cardiovascular Diseases; Cholesterol; Classification; Clinical; Coronary heart disease; Data; Devices; Diagnosis; Dose; Elderly; Event; Goals; Guidelines; Habits; Health; Heart Injuries; Heart Rate; Heart failure; Heterogeneity; Hip region structure; Hispanic; Hour; Incidence; Individual; Inflammation; Laboratories; Life; Light; Lipids; Measurement; Measures; Monitor; Movement; Myocardial Infarction; National Heart, Lung, and Blood Institute; Natriuretic Peptides; Obesity; Pathology; Patient Self-Report; Pattern; Physical Function; Physical Performance; Physical activity; Physiological; Pilot Projects; Premature Mortality; Prevalence; Prospective Studies; Prospective, cohort study; Publishing; Questionnaires; Recurrence; Regulation; Reporting; Research Personnel; Risk Factors; Silver; Stroke; Surface; Testing; Troponin; Tsunami; VO2max; Vulnerable Populations; Walking; Woman; Women' s Health; age related; aged; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; comorbidity; cost; design; disability; disability burden; evidence base; exercise capacity; follow-up; heart disease risk; heart rate monitor; heart rate variability; high risk; human very old age (85+); men; mortality; mortality risk; novel marker; older men; older women; peer; response; sedentary; sedentary lifestyle; success

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.

尽管 85 岁女性的心肌梗死和致命性冠心病 (CHD) 发生率或复发率较高 且年龄（120/1000）高于男性（85/1000），并且残疾和共病负担不成比例 与已诊断和隐匿性心血管疾病 (CVD) 相关的老年女性，在这方面预防 CVD 弱势群体的研究还远远不够。该应用程序建立在现已完成的目标之上 体力活动和心血管健康 (OPACH) 研究 (NHLBI R01 HL105065)，辅助研究 纳入由 LaCroix 博士领导的女性健康倡议长寿研究。 OPACH 团队研究 加速度计测量的体力活动 (PA) 和久坐行为 (SB) 与 CVD 事件的关系 7048 名 63-99 岁的女性。我们的主要结果显示，具有统计学显着性、剂量反应性，20% CHD 事件减少，CVD 事件减少 10%，全因死亡率减少 24% 老年女性每增加一小时轻度 PA（1.6-2.9 MET）； CVD 风险增加 12% 每多花一小时久坐。为了对轻型 PA 进行分类，OPACH 团队进行了一个实验室 校准研究（200 名 OPACH 女性）以确定与相关绝对强度相关的加速度计切点 老年女性平时的日常PA习惯。 PA 强度的年龄特定分类至关重要，因为休息时 代谢率和最大有氧能力随着年龄的增长而下降，而有氧活动的能量消耗 随着年龄的增长。由于这些与年龄相关的变化以及它们在老年人中发生方式的异质性 针对成年人，2018 年 PA 指南证据报告敦促研究人员：“对以下人群进行前瞻性队列研究： 老年人的 PA 和身体功能，包括相对的客观测量（例如心率监测器） PA 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推导经过验证的加速度计 - 测量 PA 相对强度并确定其与心血管疾病事件（CHD、心力衰竭、中风）的关联，以及 到 2027 年的死亡率。为此，我们将获得 PA 和 SB 的第二个加速度计测量值 使用非侵入式心率同步测量（PA 强度的生理测量） 为 4200-5000 名幸存 OPACH 妇女安装心脏监测贴片 (Cardea SOLO)。我们还将调查交叉 第二次加速度计磨损（2022-2023 年）时相对和绝对 PA 强度的截面关联 潜在心血管健康指标，包括传统风险因素（血脂、血糖、炎症、血液 压力、肥胖）、CVD 病理学的新型生物标志物（心肌肌钙蛋白、脑钠尿肽、半乳糖蛋白） 3)、心率变异性（来自 Cardea SOLO 补丁）和身体表现。最后，我们将确定 约 10 年内加速度计测量的 PA 和 SB 的变化与传统的变化之间的关联 同一时间间隔内的心血管危险因素、新型生物标志物和身体机能 到 2027 年临床 CVD 事件的发生率和死亡率。