WHISH-2-Prevent Heart Failure Study

摘要 心力衰竭（HF）是主要的和日益增长的公共卫生问题，特别是在老年妇女中。尽管取得了进展， 在已确诊的HF治疗中，老年人的预后仍然很差，因此需要采取预防措施。 缺乏体力活动（PA）是HF的潜在危险因素;而PA水平升高是HF的潜在危险因素。 在观察性研究中，与HF风险降低相关的证据是，维持高水平的 目前还没有发现久坐者的体力活动或增加PA可以降低心力衰竭的风险。 available.一个新的PA务实的试验嵌入在妇女健康倡议（WHI），题为WHI 健康强壮试验（WHISH）最近得到了资助，将评估增加身体健康是否 活动，减少久坐行为，通过阻力训练增加肌肉力量， 动脉粥样硬化性心血管疾病的风险，但不是HF的重要结局。WHISH-2-预防心脏病 失败将评价该RCT对HF事件和HF负担的影响（所有心力衰竭住院和 既往HF患者的CVD死亡），并进行剂量探索分析。WHISH-2-预防心脏病 失败将是有史以来在最高风险人群中进行的第一次、规模最大、时间最长的一级预防运动试验。 老年妇女HF组。嵌入式加速计研究将允许进行剂量探索分析 无论使用新开发的MET等效指数对老年女性进行RCT的结果如何。

ABSTRACT Heart failure (HF) is major and growing public health problem especially in older women. Despite advances in the treatment of established HF, prognosis remains poor in the elderly, therefore preventive efforts are needed. Lack of physical activity (PA) is a potent prospective risk factor for HF; while increased levels of PA are associated with reduced risk of HF in observational studies, the evidence that maintaining high levels of physical activity or increasing PA in sedentary individuals reduces the risk of heart failure is not presently available. A novel PA pragmatic trial embedded within the Women's Health Initiative (WHI) entitled WHI Strong and Healthy trial (WHISH) has been recently funded and will evaluate whether increasing physical activity, reducing sedentary behavior and increasing muscle strength through resistance training will reduce the risk of atherosclerotic cardiovascular disease but not the important outcome of HF. WHISH-2-Prevent Heart Failure will evaluate the effect of this RCT on incident HF and HF burden (all heart failure hospitalizations and CVD death in those with antecedent HF) as well as perform dose-finding analyses. WHISH-2-Prevent Heart Failure will be the first, largest, and longest primary prevention exercise trial ever performed in the highest risk group for HF-elderly women. An imbedded accelerometer study will allow for a dose-finding analysis regardless of the RCT results using newly developed MET-equivalent indices for elderly women.