期刊
JOURNAL OF THE AMERICAN HEART ASSOCIATION
卷 7, 期 22, 页码 -出版社
WILEY
DOI: 10.1161/JAHA.118.010078
关键词
population studies; predictors; premature ventricular beats
资金
- Finnish Heart Foundation
- Instrumentarium Science Foundation
- Onni ja Hilja Tuovinen Foundation
- Orion Research Foundation
- Paavo Nurmi Foundation
- National Heart, Lung, and Blood Institute [HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, R01 HL062181, U01HL080295, U01HL130114]
- National Institute of Neurological Disorders and Stroke
- National Institute on Aging [R01AG023629]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [U01HL130114] Funding Source: NIH RePORTER
Background-Premature ventricular contractions (PVCs) predict heart failure and death. Data regarding modifiable risk factors for PVCs are scarce. Methods and Results-We studied 1424 Cardiovascular Health Study participants randomly assigned to 24-hour Holter monitoring. Demographics, comorbidities, habits, and echocardiographic measurements were examined as predictors of PVC frequency and, among 845 participants, change in PVC frequency 5 years later. Participants exhibited a median of 0.6 (interquartile range, 0.1-7.1) PVCs per hour. Of the more directly modifiable characteristics and after multivariable adjustment, every SD increase in systolic blood pressure was associated with 9% more PVCs (95% confidence interval [CI], 2%-17%; P=0.01), regularly performing no or low-intensity exercise compared with more physical activity was associated with approximate to 15% more PVCs (95% CI, 3-25%; P=0.02), and those with a history of smoking exhibited an average of 18% more PVCs (95% CI, 3-36%; P=0.02) than did never smokers. After 5 years, PVC frequency increased from a median of 0.5 (IQR, 0.1-4.7) to 1.2 (IQR, 0.1-13.8) per hour (P<0.0001). Directly modifiable predictors of 5-year increase in PVCs, described as the odds per each quintile increase in PVCs, included increased diastolic blood pressure (odds ratio per SD increase, 1.16; 95% CI, 1.02-1.31; P=0.02) and a history of smoking (OR, 1.31; 95% CI, 1.02-1.68; P=0.04). Conclusions-Enhancing physical activity, smoking cessation, and aggressive control of blood pressure may represent fruitful strategies to mitigate PVC frequency and PVC-associated adverse outcomes.
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