노인여성에서 심폐기능과 혈관 경직도의 상관관계
Association between cardiorespiratory fitness and arterial stiffness in older women.
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노화는 심폐기능을 저하시키고, 혈관의 구조적, 기능적 변화를 초래하여 동맥경직도를 상승시킴으로 심혈관계 질환의 위험성으로 높이는 것으로 알려져 있다. 그러나 규칙적으로 운동을 지속해온 노인의 경우, 노화로 인한 심폐기능 저하와 동맥경직도 증가 현상이 적은 것으로 나타났다. 이에 따라, 본 연구의 목적은 노년기 여성을 대상으로 심폐기능과 동맥경직도와의 상관성에 대해 알아보고자 하였다. 연구 대상은 평균나이 62±3세의 28명 노년기 여성으로 하였으며, 연구 참가자 모두 신체계측, 체성분검사, 혈액검사(총 콜레스테롤, 중성지방, 고밀도 지단백 콜레스테롤, 저밀도 지단백 콜레스테롤, 인슐린, 글루코스, hs-CRP), 심폐기능 측정, 동맥경직도 지표로서 경동맥-대퇴동맥 맥파전파속도를 측정하였다. 연구 결과, 경동맥-대퇴동맥 맥파전파속도는 최대산소섭취량과 통계적으로 유의한 음의 상관을 보였으며(r=-0.53 p=.002) 또한 나이(r=.323, p=.047), 상완동맥 수축기혈압(r=.682, p=.001), 상완동맥 이완기혈압(r=.710, p=.001)과 유의한 양의 상관을 보였다. 또한 다중회귀분석 결과, 최대산소섭취량과 상완동맥 이완기 혈압은 경동맥-대퇴동맥 맥파전파속도의 독립적 예측인자인 것으로 나타났다. 이에 따라, 높은 수준의 심폐기능을 유지 하는 것이 노년기 여성에서 향후 발생할 수 있는 심혈관계 질환을 예방하기 위해 필요할 것으로 사료된다.
Abstract
Aging has a negative effect on large elastic artery structure and function which increases the risk of cardiovascular disease. Pulse wave velocity, an index of arterial stiffness, is associated with high risk of cardiovascular disease. Although some studies suggested that high cardiorespiratory fitness (CRF) levels are associated with enhanced arterial function in older men, little is known that association between CRF and arterial stiffness in older women. We tested the hypothesis that higher levels of CRF are inversely associated with arterial stiffness in a cross sectional study of 28 older women (62 ±3 yrs). Body composition was analyzed using bioelectrical impedance and blood samples were derived after 8 hours overnight fast. Cardiorespiratory fitness was directly measured by maximal exercise treadmill test with expired gas analysis. Arterial stiffness was derived from carotid to femoral pulse wave velocity (PWV). PWV was significantly correlated with age (r=.323, p=.047), systolic blood pressure (r=.682, p=.001), diastolic blood pressure (r=.710, p=.001) and CRF (r=-0.53 p=.002). In multivariable regression models, PWV was associated with diastolic blood pressure and CRF (β=-0.463, p=.046). These results demonstrate that high CRF is associated with arterial stiffness independently of cardiovascular risk factors in older women, which may contribute to lower incidence of cardiovascular disease seen in higher fit older women.
참고문헌 (41)
- 주요 만성질환 유병률, "보건복지부, 한국보건사회연구원", ~ (2005)
- Aggoun, Y, "Arterial mechanical changes in children with familial hypercholesterolemia", Arteriosclerosis, thrombosis, and vascularbiology, 20, pp.2070~2075 (2000)
- Amar, J, "Arterial stiffness and cardiovascular risk factors in a population-based study", Journal of Hypertension, 19, pp.381~387 (2001)
- Benetos, A, "Determinants of accelerated progression of arterial stiffness in normotensive subjects and in treated hypertensive subjects over a 6-year period", Circulation, 105, pp.1202~1207 (2002)
- Binder, J, "Aortic augmentation index is inversely associated with cardiorespiratory fitness in men without known coronary heart disease", American Journal of Hypertension, 19(10), pp.1019~1024 (2006)
- Blacher, J, "Impact of aortic stiffness on survival in end-stage renal disease", Circulation, 99, pp.2434~2439 (1999)
- Boreham, C. A, "Cardiorespiratory fitness, physical activity, and arterial stiffness: the Northern Ireland Young Hearts Project", Hypertension, 44(5), pp.721~726 (2004)
- Cameron, J. D, "Exercise training increases total systemic arterial compliance in humans", American Journal of Physiology, 266, pp.H693~H701 (1994)
- Carter, J. B, "Effect of endurance exercise on autonomic control of heart rate", Sports medicine, Circulation, 107(1), pp.139~146 (2003)
- Cruickshank, K, "Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function?", Circulation, 106, pp.2085~2090 (2002)
- Eskurza, I, "Changes in maximal aerobic capacity with age in endurance-trained women: 7-yr follow-up", Journal of Applied Physiology, 92(6), pp.2303~2308 (2002)
- Evenson, K. R, "Effect of cardiorespiratory fitness on mortality among hypertensive and normotensive women and men", Epidemiology, 15, pp.565~572 (2004)
- Ferreira, I, "Current and adolescent body fatness and fat distribution: relationships with carotid intima-media thickness and large artery stiffness at the age of 36 years", Journal of Hypertension, 22, pp.145~155 (2004)
- Ferreira, I, "Current and adolescent levels of cardiopulmonary fitness are related to large artery properties at age 36: the Amsterdam Growth and Health Longitudinal Study", European Journal of clinical investigation, 32, pp.723~731 (2002)
- Heffernan, K. S, "Arterial stiffness and wave reflection following exercise in resistance trained men", Medicine and science in sports and exercise, 39, pp.842~848 (2007)
- Jae, S. Y, "Association between cardiorespiratory fitness and prevalence of carotid atherosclerosis among men with hypertension", American Heart Journal, 153, pp.1001~1005 (2007)
- Kadoglou, N. P. E, "Exercise and carotid atherosclerosis", European journal of vascular and endovascular surgery, 35, pp.264~272 (2008)
- Kasch, F. W, "The effect of physical activity and inactivity on aerobic power in older men (a longitudinal study)", Physician and Sports Medicine, 18(4), pp.73~83 (1990)
- Kingwell, B. A, "Large artery stiffness: implications for exercise capacity and cardiovascular risk", Clinical and experimental pharmacology & physiology, 29(3), pp.214~217 (2002)
- Kingwell, B. A, "Large artery stiffness: structural and genetic aspects", Clinical and experimental pharmacology & physiology, 28, pp.1040~1043 (2001)
- Kokkinos, P, "Exercise capacity and mortality in hypertensive men with and without additional risk factors", Hypertension, 53(3), pp.494~499 (2009), 494-499.
- Kokkinos, P, "Exercise capacity and all-cause mortality in prehypertensive men", American Journal of Hypertension, 22(7), pp.735~741 (2009), 735-741.
- Kool, M. J, "Effects of diurnal variability and exercise training on properties of large arteries", Journal of Hypertension, 10, pp.S49~S52 (1992)
- Lakatta, E. G, "Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a "set up" for vascular disease", Circulation, 107(1), pp.139~146 (2003)
- Laurent, S, "Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients", Hypertension, 37, pp.1236~1241 (2001)
- Moreau, K. L, "Regular exercise, hormone replacement therapy and the age-related decline in carotid arterial compliance in healthy women", Cardiovascular research, 57, pp.861~868 (2003)
- Pearson, T. A, "AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee", Circulation, 106(3), pp.388~391 (2002)
- Schmidt-Trucksass, A, "Arterial properties of the carotid and femoral artery in endurance-trained and paraplegic subjects", Journal of Applied Physiology, 89, pp.1956~1963 (2000)
- Schram, M. T, "Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study", Hypertension, 43, pp.176~181 (2004)
- Seals, D. R, "Habitual exercise and arterial aging", Journal of Applied Physiology, 105(4), pp.1323~1332 (2008)
- Sesso, H. D, "Physical activity and coronary heart disease in men: The Harvard Alumni Health Study", Circulation, 102(9), pp.975~980 (2002)
- Stewart, K. J, "Physical activity and aging", Annals of the New York Academy of Sciences, 105, pp.193~206 (2005)
- Sutton-Tyrrell, K, "Elevated aortic pulse wave velocity, a marker of arterial stiffness, predicts cardiovascular events in well-functioning older adults", Circulation, 111, pp.3384~3390 (2005)
- Tanaka, H, "Absence of age-related increase in central arterial stiffness in physically active women", Arteriosclerosis, thrombosis, and vascular biology, 18, pp.127~132 (1998)
- Tanaka, H, "Aging, habitual exercise, and dynamic arterial compliance", Circulation, 102, pp.1270~1275 (2000)
- Tounian, P, "Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study", Lancet, 358, pp.1400~1404 (2001)
- Vaitkevicius, P. V, "Effects of age and aerobic capacity on arterial stiffness in healthy adults", Circulation, 88, pp.1456~1462 (1993)
- Van Bortel, L. M, "Clinical applications of arterial stiffness, task force III: recommendations for user procedures", American Journal of Hypertension, 15, pp.445~452 (2002)
- Wei, M, "Low cardiorespiratory fitness and physical inactivity as predictors of mortality in men with type 2 diabetes", Annals of internal medicine, 132(8), pp.605~611 (2002)
- Wildman, R. P, "Measures of obesity are associated with vascular stiffness in young and older adults", Hypertension, 42, pp.468~473 (2003)
- Wilkinson, I. B, "Reproducibility of pulse wave velocity and augmentation index measured by pulse wave analysis", Journal of Hypertension, 16, pp.2079~2084 (1998)