Heart:心血管患者的福音:定期洗澡降低心血管疾病发作风险!

2020-03-26 转化医学网 转化医学网

心血管病死亡占我国居民疾病死亡构成40%以上,居首位,已经超越癌症成为 “头号杀手”,发病率高、致残率高、死亡率高、复发率高、并发症多,对健康危害极为严重。

有效防治心血管病不仅对中国来说困难重重,从世界范围上来说也是一个严峻的挑战,除了临床治疗以外,生活方式的干预也是重中之重。

近日,发表在《Heart》杂志上的一项长期研究表明,经常洗澡可以降低死于心脏病和中风的风险。研究表明,“频率”越高,对心血管的保护越好,每天洗一次热水澡似乎比每周洗一两次更具保护作用。

之前已有研究证明了盆浴暴露的热量是预防CVD的潜在手段。热暴露对糖尿病控制的影响最早是从1998年发表的一份报告中提出的,该报告要求八名2型糖尿病参与者每天在浴缸中洗澡30分钟,每周6天,共3周,结果发现,参与者的平均空腹血糖降低了20%,平均糖基化血红蛋白降低了10%。后来的前瞻性研究还报道了其对血压和体重控制的进一步影响。但它对心血管疾病风险的长期影响,包括心脏病发作、心源性猝死和中风,至今仍然是未解之谜。

Laukkanen等人采用了一项基于人群的为期6年的前瞻性队列研究,结果表明,桑拿浴与降低心脏猝死和致命性CVD的风险有关。然而,盆浴对心血管健康的益处尚待观察调查。浴缸沐浴可提供水压,增加中风量和心输出量,并降低总的外周血管阻力。它还与良好的睡眠质量和自我评估的健康有关。相反,它也可能与猝死相关,尤其是在老年人群中,由于体温的快速变化引发的意外溺水或心脏病发作,或者中风患者导致汗液无法控制体温升高引发的中暑。

为了进一步探索这个问题,该研究团队进行了基于日本公共卫生中心的研究队列I是一项基于人群的前瞻性研究,根据国家名称,来自五个公共卫生中心地区(秋田,岩手,东京,长野和冲绳)的61595名40-59岁的日本成年人。由于没有发病率数据,因此将东京的参与者排除在外,使用了45168名符合随访条件的参与者进行本次分析。

在1990年开始这项研究时,约有43000名参与者完成了一份关于他们洗澡习惯和潜在影响因素的详细调查问卷:生活方式,包括运动、饮食、酒精摄入、体重(BMI)、平均睡眠时间、病史和当前药物使用情况。

至2009年12月底,每个参与者都被监测到死亡或完成研究,以先到者为准,最后以30076人为基础进行分析。

在随访期间,发生了2097例心血管疾病事件:275例心脏病发作;53例心源性猝死;1769例中风。

在排除了潜在影响因素后,对数据的分析表明,与每周一至两次泡澡或根本不泡澡相比,每天洗热水澡可以降低28%的心血管疾病总风险,降低26%的中风总风险,而浴缸浴的频率与心源性猝死的风险增加无关。

对优选水温的进一步分析表明,温水和热水的总心血管疾病风险分别降低了26%和35%。但总体卒中风险与水温却并没有显着相关性。

根据浴缸洗澡频率计算的心血管疾病发作的卡普兰-迈耶累积自由比例曲线

本次研究的优势包括前瞻性设计,冠心病和中风发生率的系统性注册,使用来自一般人群的大量样本以及较长的随访时间。大样本量和长期随访使研究人员能够在排除早期心血管事件参与者后进行分析,这减少了因果关系逆转的可能性。尽管如此,该研究依然存在一些限制。

首先,有关浴缸沐浴频率的信息仅在基线时获得。因此,参与者可能在随访期间改变了他们的频率。

其次,由于发现经常在浴缸里洗澡的人受过高等教育,并且是上班族,因此浴缸洗澡的频率可能是较高社会经济状况的行为标志。但是,浴缸沐浴与患病风险之间呈负相关,在调整了这些社会经济变量后,CVD结果仍具有统计学意义。

第三,研究人员也没有询问较少在浴缸中洗澡的原因。对于某些人来说,这可能是由于疾病或疾病可能增加CVD的风险所致。但在排除发生CVD或在基线5年或10年内死亡的参与者后,浴缸洗澡频率与总CVD风险之间的关联并没有实质性改变,仍然具有统计学意义。

原始出处:

Tomohiko Ukai, et al. Habitual tub bathing and risks of incident coronary heart disease and stroke. Heart (2020). DOI:10.1136/heartjnl-2019-3157522.

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    2020-08-07 咻凡

    学好了!

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    2020-03-28 zhaojie88
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    2020-03-28 baoya
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    2020-03-28 slcumt

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