2项新证据!运动有益健康:延缓心脏衰老、降低心衰风险
2018/05/27
近日,科学家们又找到了“运动有益健康”的新证据。一篇论文称,每周锻炼4-5天对保持心脏年轻是必要的;另一项成果表明,在中年时,增加身体活动至推荐水平6年与患心力衰竭风险显著降低有关。


图片来源:The Journal of Physiology(https://doi.org/10.1113/JP275301)

论文一:一周运动4-5次延缓心脏衰老

随着年龄的增长,动脉(负责输送血液进出心脏)容易硬化,从而增加患心脏病的风险。5月20日,发表在The Journal of Physiology杂志上题为“The effect of lifelong exercise frequency on arterial stiffness”的研究表明,不同大小的动脉受不同运动量的影响是不同的。具体来说,每周运动2-3天可能就足以使中等大小的动脉的硬化程度缩到最小,而每周运动4-5天才能使较大的中央动脉(central arteries)保持年轻。

具体来说,在这项研究中,科学家们对102名60岁以上的参与者进行了横断面调查(cross-sectional examination)。他们收集了所有参与者动脉硬化的详细测量数据,之后依据一生的运动历史将参与者分为4组:1)久坐组(每周运动小于2次,每次运动至少30分钟,后同);2)偶尔运动组(每周运动2-3次);3)坚持运动组(每周运动4-5次);4)狂热运动组(每周运动6-7次)。

分析结果显示,偶尔运动会导致更多年轻的中等大小的动脉这类动脉为头部和颈部提供含氧血),而坚持运动的人拥有更年轻的大中枢动脉这类动脉向胸部和腹部供血以及更健康的中等大小的动脉。

领导该研究的Benjamin Levine说:“这项工作是非常令人兴奋的,因为它使我们能够制定锻炼计划来让心脏保持年轻,甚至让较老的心脏和血管 “恢复青春”turn back time)。我们先前的研究表明,等到70岁再去逆转心脏的衰老已经太晚了,因为即便是一年的训练也很难改变心血管的结构。我们目前的工作聚焦在对有或无心脏病风险因素的中年男性和女性进行为期2年的训练,以调查是否能够通过在对的时间用正确的运动量来逆转心脏和血管的衰老。


图片来源:Circulation(https://doi.org/10.1161/CIRCULATIONAHA.117.030226)

论文二:运动或可降低心力衰竭风险

5月15日,发表在Circulation杂志上题为“Six-Year Changes in Physical Activity and the Risk of Incident Heart Failure”的另一项研究通过分析11,000多名美国成年人的身体活动水平发现,增加身体活动至推荐水平6年与患心力衰竭风险显著降低有关。同时,在中年时,仅6年没有身体活动(as little as six years without physical activity)也与患该疾病的风险增加有关。

事实上,先前已有多项研究表明,身体更活跃的人(people who are more physically active)患心力衰竭的风险更低。但是,运动水平随时间变化对患心力衰竭风险的影响还并不清楚,例如,如果一个人一生中最初大部分时间是久坐不动的,但在中年时开始运动,这会降低患心力衰竭的风险吗?或者,如果一个人最初经常运动,但到中年时不再运动了,这会增加患心力衰竭的风险吗?

为了回答这一问题,该研究使用了来自ARIC研究中11,351名参与者的数据ARIC:Atherosclerosis Risk in Communities)。这些参与者平均年龄为60岁,57%的人是女性。研究人员利用电话访问、医院记录和死亡证明等途径监测(平均19年)参与者发生的心血管疾病事件,如心脏病发作、中风和心力衰竭。调查期间,有1693人住院治疗,57人因心力衰竭死亡。

此外,在第一次和第三次ARIC研究中(间隔6年),参与者还被调查了他们的身体活动水平。研究人员依据美国心脏协会发布的指南将他们的活动水平分为3类:1)差(poor,即完全没有运动)、2)中等(intermediate,每周进行1-74分钟剧烈运动或1-149分钟中等强度运动)和3)推荐(recommended,每周至少进行75分钟的剧烈运动,或至少150分钟的中等强度运动)。

在第3次访问时,42%(4,733)的参与者称他们达到了“推荐水平”;23%(2,594)的参与者称他们达到了“中等水平”;35%(4,024)的参与者称他们的运动水平属于“差”。与第一次访问时相比,24%的参与者增加了他们的身体活动,22%的参与者降低了他们的身体活动,54%的参与者保持了相同的运动量。


图片来源:16sucai

分析结果表明,那些在第一和第三次调查都保持“推荐运动水平”的人表现出了与患心力衰竭风险降低最强的相关性,与运动水平始终保持“差”的参与者相比,风险降低了31%。此外,与运动水平始终保持“差”或“中等”的参与者相比,那些增加身体活动(运动水平)的参与者(从“差”增加到“中等”或“推荐”,或从“中等”增加到“推荐)患心力衰竭的风险降低了约12%。相反,与运动水平始终保持“推荐”或“中等”的参与者相比,那些降低身体活动(运动水平)的参与者患心力衰竭的风险增加了约18%。

领导该研究的Chiadi Ndumele博士说:“我们的研究结果表明,在中年时每周坚持进行150分钟的中度运动或剧烈运动(如快走、骑自行车)可能足以使患心力衰竭的风险降低31%。此外,在中年时,将运动水平从‘不运动’调整为‘推荐运动水平’超过6年可能会使患心力衰竭的风险降低23%。”

不过,科学家们强调,由于这是一项观察性研究,因此不能证明运动与心力衰竭之间的直接因果关系。但是,他们认为,从中年人身上收集到的数据表明,通过适度的锻炼来降低患心力衰竭的风险可能永远都不会太晚。

责编:风铃

参考资料:

Exercise to stay young: 4-5 days a week to slow down your heart's aging

Six years of exercise—or lack of it—may be enough to change heart failure risk

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  • The effect of lifelong exercise frequency on arterial stiffness

    Central arterial stiffness increases with sedentary aging. While near‐daily, vigorous lifelong (>25 yr) endurance exercise training prevents arterial stiffening with aging, this rigorous routine of exercise training over a lifetime is impractical for most individuals. The aim was to examine whether a less frequent ‘dose’ of lifelong exercise training (4‐5 sessions/wk for > 30 min) that is consistent with current physical activity recommendations elicits similar benefits on central arterial stiffening with aging. A cross‐sectional examination of 102 seniors (>60 yrs old), who had a consistent lifelong exercise history was performed. Subjects were stratified into 4 groups based on exercise frequency as an index of exercise ‘dose’: sedentary: < 2 sessions/wk; casual exercisers: 2–3 sessions/wk; committed exercisers: 4–5 sessions/wk; Masters athletes: 6–7 sessions/wk plus regular competitions. Detailed measures of arterial stiffness and left ventricular afterload were collected. Biological aortic age and central PWV were younger in committed exercisers and Masters athletes compared to sedentary seniors. TACi (total arterial compliance) was lower, while Carotid β‐stiffness index and Eai (effective arterial elastance) were higher in sedentary seniors compared to the other groups. There appeared to be a dose‐response threshold for carotid β‐stiffness index and TACi. Peripheral arterial stiffness was not significantly different among the groups. These data suggest that 4–5 weekly exercise sessions over a lifetime is associated with reduced central arterial stiffness in the elderly. A less frequent dose of lifelong exercise (2‐3 sessions/wk) is associated with decreased ventricular afterload and peripheral resistance, while peripheral arterial stiffness is unaffected by any dose of exercise.

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  • Six-Year Changes in Physical Activity and the Risk of Incident Heart Failure

    Background: Higher physical activity (PA) is associated with lower heart failure (HF) risk; however, the effect of changes in PA on HF risk is unknown. Methods: We evaluated 11 351 ARIC study (Atherosclerosis Risk in Communities) participants (mean age 60 years) who attended visit 3 (1993–1995) and did not have a history of cardiovascular disease. Exercise PA was assessed using a modified Baecke questionnaire and categorized according to American Heart Association guidelines as recommended, intermediate, or poor. We used Cox regression models to characterize the association of 6-year changes in PA between the first (1987–1989) and third ARIC visits and HF risk. Results: During a median of 19 years of follow-up, 1750 HF events occurred. Compared with those with poor activity at both visits, the lowest HF risk was seen for those with persistently recommended activity (hazard ratio, 0.69; 95% confidence interval, 0.60–0.80). However, those whose PA increased from poor to recommended also had reduced HF risk (hazard ratio, 0.77; 95% confidence interval 0.63–0.93). Among participants with poor baseline activity, each 1 SD higher PA at 6 years (512.5 METS*minutes/week, corresponding to ≈30 minutes of brisk walking 4 times per week) was associated with significantly lower future HF risk (hazard ratio, 0.89, 95% confidence interval, 0.82–0.96). Conclusions: Although maintaining recommended activity levels is associated with the lowest HF risk, initiating and increasing PA, even in late middle age, are also linked to lower HF risk. Augmenting PA may be an important component of strategies to prevent HF.

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