背景:高认知储备(CR)与较低的痴呆风险有关,但其与心脏病(HD)的关联尚不清楚。我们旨在探讨CR与HD和心脏结构和功能的关系。
结果:在英国生物银行内,对349907名无HD参与者进行了随访。生成了一个复合CR指标,涉及教育/职业素养/电视观看时间/公开频率/社会联系频率/各种休闲活动,并进一步分为低/中/高水平。突发事件HD,包括冠状动脉HD,心律失常,心力衰竭,是根据医疗记录确定的。在后续行动中,一个子样本(n=31182)接受了心脏磁共振成像,以评估心室结构和功能.数据采用Cox回归分析,拉普拉斯回归,和线性回归。与低CR相比,高CR的任何HD的风险比和95%CI为0.78(0.75-0.80)(包括冠状动脉HD的0.68[0.66-0.71],0.91[0.87-0.95]用于心律失常,心力衰竭为0.63[0.58-0.68])。此外,与低CR相比,高CR与1.59(95%CI,1.37-1.82)年的HD延迟发病相关.在心脏磁共振成像数据分析中,与低CR相比,高CR与较大的左心室舒张末期容积(β,0.13[95%CI,0.09-0.17]),左心室收缩末期容积(β,0.05[95%CI,0.01-0.10]),左心室每搏输出量(β,0.16[95%CI,0.12-0.21]),和左心室射血分数(β,0.08[95%CI,0.03-0.13])。
结论:高CR与良好的HD健康相关。我们的发现表明,CR的有益作用不仅限于痴呆症,还包括HD。
BACKGROUND: High cognitive reserve (CR) has been related to lower dementia risk, but its association with heart disease (HD) is unknown. We aimed to explore the relation of CR to HD and cardiac structure and function.
RESULTS: Within the UK Biobank, 349 907 HD-free participants were followed up. A composite CR indicator involving education/occupation attainment/television viewing time/confiding frequency/social connection frequency/variety of leisure activities was generated, and further categorized into low/moderate/high levels. Incident HD, including coronary HD, cardiac arrhythmia, and heart failure, was ascertained on the basis of medical records. During the follow-up, a subsample (n=31 182) underwent cardiac magnetic resonance imaging to assess ventricular structure and function. Data were analyzed using Cox regression, Laplace regression, and linear regression. Compared with low CR, the hazard ratio and 95% CI of any HD for high CR was 0.78 (0.75-0.80) (including 0.68 [0.66-0.71] for coronary HD, 0.91 [0.87-0.95] for cardiac arrhythmia, and 0.63 [0.58-0.68] for heart failure). Furthermore, high CR was associated with delayed HD onset by 1.59 (95% CI, 1.37-1.82) years compared with low CR. In cardiac magnetic resonance imaging data analysis, compared with low CR, high CR was associated with larger left ventricular end-diastolic volume (β, 0.13 [95% CI, 0.09-0.17]), left ventricular end-systolic volume (β, 0.05 [95% CI, 0.01-0.10]), left ventricular stroke volume (β, 0.16 [95% CI, 0.12-0.21]), and left ventricular ejection fraction (β, 0.08 [95% CI, 0.03-0.13]).
CONCLUSIONS: High CR is associated with favorable HD health. Our findings suggest that the beneficial effect of CR is not limited to dementia but also HD.