2024-02-21 バッファロー大学(UB)
Light daily activities like walking at a normal pace or doing household chores can have tremendous benefits for heart health, according to a new UB study.
<関連情報>
- https://www.buffalo.edu/news/releases/2024/02/lamonte-jama-cardiology-heart-failure.html
- https://jamanetwork.com/journals/jamacardiology/article-abstract/2815080
63～99歳の女性における加速度計による身体活動、座位時間、および心不全リスクの測定 Accelerometer-Measured Physical Activity, Sedentary Time, and Heart Failure Risk in Women Aged 63 to 99 Years
Michael J. LaMonte, PhD, MPH Andrea Z. LaCroix, PhD, MPH; Steve Nguyen, PhD2; et al
JAMA Cardiology Published:February 21, 2024
DOI:10.1001/jamacardio.2023.5692
Key Points
Question Are accelerometer-measured physical activity (PA) and sedentary behavior associated with incident heart failure in older women?
Findings In this cohort study of 5951 women aged 63 to 99 years, usual daily light PA, moderate to vigorous PA, and steps per day were inversely associated, and total sedentary time positively associated, with overall heart failure and its subtype with preserved ejection fraction. These exposures were not associated with heart failure with reduced ejection fraction.
Meaning Results suggest that promoting regular PA and minimal sedentary time in older women may be prudent for primary prevention of heart failure and its subtype with preserved ejection fraction for which treatment is limited.
Abstract
Importance Heart failure (HF) prevention is paramount to public health in the 21st century.
Objective To examine incident HF and its subtypes with preserved ejection fraction (HFpEF) and reduced EF (HFrEF) according to accelerometer-measured physical activity (PA) and sedentary time.
Design, Setting, and Participants This was a prospective cohort study, the Objective Physical Activity and Cardiovascular Health (OPACH) in Older Women study, conducted from March 2012 to April 2014. Included in the analysis were women aged 63 to 99 years without known HF, who completed hip-worn triaxial accelerometry for 7 consecutive days. Follow-up for incident HF occurred through February 2022. Data were analyzed from March to December 2023.
Exposure Daily PA (total, light, moderate to vigorous PA [MVPA], steps) and sedentary (total, mean bout duration) behavior.
Main Outcomes and Measures Adjudicated incident HF, HFpEF, and HFrEF.
Results A total of 5951 women (mean [SD] age, 78.6 [6.8] years) without known HF were included in this analysis. Women self-identified with the following race and ethnicity categories: 2004 non-Hispanic Black (33.7%), 1022 Hispanic (17.2%), and 2925 non-Hispanic White (49.2%). There were 407 HF cases (257 HFpEF; 110 HFrEF) identified through a mean (SD) of 7.5 (2.6) years (range, 0.01-9.9 years) of follow-up. Fully adjusted hazard ratios (HRs) for overall HF, HFpEF, and HFrEF associated with a 1-SD increment were 0.85 (95% CI, 0.75-0.95), 0.78 (95% CI, 0.67-0.91), and 1.02 (95% CI, 0.81-1.28) for minutes per day total PA; 0.74 (95% CI, 0.63-0.88), 0.71 (95% CI, 0.57-0.88), and 0.83 (95% CI, 0.62-1.12) for steps per day; and 1.17 (95% CI, 1.04-1.33), 1.29 (95% CI, 1.10-1.51), and 0.94 (95% CI, 0.75-1.18) for minutes per day total sedentary. Cubic spline curves for overall HF and HFpEF were significant inverse for total PA and steps per day and positive for total sedentary. Light PA and MVPA were inversely associated with overall HF (HR per 1 SD: 0.88; 95% CI, 0.78-0.98 and 0.84; 95% CI, 0.73-0.97) and HFpEF (0.80; 95% CI, 0.70-0.93 and 0.85; 95% CI, 0.72-1.01) but not HFrEF. Associations did not meaningfully differ when stratified by age, race and ethnicity, body mass index, physical function, or comorbidity score. Results for sedentary bout duration were inconsistent.
Conclusions and Relevance Higher accelerometer-measured PA (MVPA, light PA, steps per day) was associated with lower risk (and greater total sedentary time with higher risk) of overall HF and HFpEF in a racially and ethnically diverse cohort of older women. Increasing PA and reducing sedentary time for primary HFpEF prevention may have relevant implications for cardiovascular resilience and healthy aging in later life.
