運動量の多い高齢者は心疾患のリスクが低い
高齢者にとって身体活動は心血管疾患を予防するために推奨されているが、特に75歳以上の高齢者においてそれらの関連性を明確に示した研究は少ない。これに関して、大規模な追跡調査の結果が出た。
1989年−1990年の間に73歳の心血管疾患のない米国人男女4207人がエントリーし、10年にわたって追跡調査(コホート研究)が行われた。
歩行速度や距離などの歩行ステータスと、レジャー活動や運動強度、心血管疾患イベントが記録された。
結果は、41995人年のうち心血管疾患イベントは1182回だった。
多変量調整を行うと、身体活動が多いほど冠動脈性心疾患、脳卒中(特に虚血性脳梗塞)、全ての心血管疾患のリスクが低いことが示された。
歩行速度、距離、歩行スコア、レジャー活動、運動強度それぞれの因子が低疾患リスクとの関連があった。 例えば2マイル/時(0.89m/s)以下で歩く人に比べて、3マイル/時(1.34m/s)で歩く人の方が冠状動脈性心疾患(HR:0.50; CI:0.38-0.67)、脳卒中(HR:0.47; CI:0.33-0.66)、心血管疾患(HR:0.50; CI:0.40-0.62)のリスクが低かった。(HR=ハザード比,CR=信頼区間)
Physical Activity and Risk of Coronary Heart Disease and Stroke in Older Adults: The Cardiovascular Health Study
Circulation. 2015 Nov 4. pii: CIRCULATIONAHA.115.018323. [Epub ahead of print] doi:10.1161/CIRCULATIONAHA.115.018323
Abstract
Background While guidelines suggest that older adults engage in regular physical activity (PA) to reduce cardiovascular disease (CVD), surprisingly few studies have evaluated this relationship, especially in those older than 75 years. Additionally, with advancing age the ability to perform some types of PA might decrease, making light-moderate exercise such as walking especially important to meet recommendations. Methods and Results Prospective cohort analysis among 4207 US men and women of mean age 73 years (SD=6) who were free of CVD at baseline in the Cardiovascular Health Study and followed from 1989 to 1999. PA was assessed and cumulatively updated over time to minimize misclassification and assess long-term effects of habitual activity. Walking (pace, blocks, combined walking score) was updated annually from baseline through 1999. Leisure-time activity and exercise intensity were updated at baseline, 1992, and 1996. Incident CVD (fatal or nonfatal myocardial infarction, coronary death, or stroke) was adjudicated using medical records. During 41 995 person-years of follow-up, 1182 CVD events occurred. After multivariable adjustment, greater PA was inversely associated with coronary heart disease (CHD), stroke (especially ischemic stroke), and total CVD, even in those 75 years and older. Walking pace, distance, and overall walking score, leisure-time activity, and exercise intensity were each associated with lower risk. For example, compared with a walking pace under 2 mph, those that habitually walked at a pace above 3 mph had lower risk of CHD (0.50; CI:0.38-0.67), stroke (0.47; CI:033-0.66) and CVD (0.50; CI:0.40-0.62). Conclusions These data provide empiric suggestion supporting PA recommendations, in particular walking, to reduce incidence of CVD among older adults.
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