Objective Physical Activity and Cardiovascular Health in Older Women: OPACH2

尽管85岁以上的女性发生或复发心肌梗死和致死性冠心病（CHD）的几率较高， 和老年人（120/1 000）比男性（85/1 000），残疾和合并症的负担不成比例， 老年妇女与诊断和隐匿性心血管疾病（CVD），预防心血管疾病， 弱势群体的研究严重不足。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 R 01 HL 105065），辅助研究 嵌入到由LaCroix博士领导的女性健康倡议长寿研究中。OPACH小组研究了 加速度计测量的身体活动（PA）和久坐行为（SB）与CVD事件之间的关系 7048名63-99岁的妇女。我们的初步结果显示，20%的剂量反应性具有统计学显著性， CHD发病率降低10%，CVD发病率降低10%，全因死亡率降低24%。 老年妇女每增加一小时的光PA（1.6-2.9 MET）; 每多坐一个小时为了对轻PA进行分类，OPACH小组进行了一项实验室研究， 校准研究（200名OPACH女性），以确定与以下各项相关的绝对强度的加速度计临界点： 老年妇女的日常PA习惯。PA强度的特定分类是至关重要的，因为休息 代谢率和最大有氧能力随增龄而下降，而有氧活动的能量消耗 随着年龄增长。由于这些与年龄有关的变化以及它们在老年人中发生的异质性， 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PA和身体功能，包括客观测量（例如，心率监测器） 的强度”。在本文中，术语“相对”是指个体的最大运动能力。 OPACH 2和OPACH 2校准研究专门设计用于推导经验证的加速度计- 测量PA相对强度，并确定其与CVD事件（CHD、心力衰竭、卒中）的相关性， 死亡率到2027年。为此，我们将获得PA和SB的第二个加速度计测量值， 使用非侵入性测量仪同时测量心率（PA强度的生理测量） 心脏监测贴片（Cardea SOLO）在4200-5000名存活的OPACH女性中的应用。我们也会调查交叉- 在第二加速度计磨损（2022-2023）处的相对和绝对PA强度与 基础心血管健康指标，包括传统风险因素（血脂、血脂、炎症、血液 血压，肥胖），CVD病理学的新生物标志物（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）和身体表现。最后，我们将确定 2010年来加速度计测量的PA和SB的变化与传统 心血管危险因素、新的生物标志物和身体功能， 到2027年的临床CVD事件发生率和死亡率。

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.