Physical inactivity and idiopathic pulmonary embolism in women: prospective study -- Kabrhel et al. 343 -- bmj.com

BMJ 2011; 343:d3867 doi: 10.1136/bmj.d3867 (Published 4 July 2011)
Cite this as: BMJ 2011; 343:d3867

* Research

Physical inactivity and idiopathic pulmonary embolism in women: prospective study
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1. Christopher Kabrhel, attending physician 1, assistant professor of surgery 2,
2. Raphaëlle Varraso, researcher/epidemiologist34,
3. Samuel Z Goldhaber, attending physician 5, professor of medicine2,
4. Eric Rimm, associate professor67,
5. Carlos A Camargo Jr, attending physician 1, associate professor7

+ Author Affiliations

1. 1Department of Emergency Medicine, Massachusetts General Hospital, MA, USA
2. 2Harvard Medical School, Boston, MA
3. 3INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology Team, F-94807, Villejuif, France
4. 4Université Paris Sud 11, UMRS 1018, F-94807, Villejuif
5. 5Department of Medicine, Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
6. 6Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA
7. 7Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA

1. Correspondence to: C Kabrhel, Department of Emergency Medicine, Massachusetts General Hospital, Zero Emerson Place, Suite 3B, Boston, MA 02114 ckabrhel@partners.org

* Accepted 28 April 2011

Abstract

Objectives To determine the association between physical inactivity (that is, a sedentary lifestyle) and incident idiopathic pulmonary embolism.

Design Prospective cohort study.

Setting Nurses’ Health Study.

Participants 69 950 female nurses who completed biennial questionnaires from 1990 to 2008.

Main outcome measures The primary outcome was idiopathic pulmonary embolism confirmed in medical records. Multivariable Cox proportional hazards models controlled for age, body mass index (BMI), energy intake, smoking, pack years, race, spouse’s educational attainment, parity, menopause, non-aspirin non-steroidal anti-inflammatory drugs, warfarin, multivitamin supplements, hypertension, coronary heart disease, rheumatological disease, and dietary patterns. The primary exposure was physical inactivity, measured in hours of sitting each day. The secondary exposure was physical activity, measured in metabolic equivalents a day.

Results Over the 18 year study period, there were 268 cases of incident idiopathic pulmonary embolism. There was an association between time of sitting and risk of idiopathic pulmonary embolism (41/104 720 v 16/14 565 cases in most inactive v least inactive in combined data; P<0.001 for trend). The risk of pulmonary embolism was more than twofold in women who spent the most time sitting compared with those who spent the least time sitting (multivariable hazard ratio 2.34, 95% confidence interval 1.30 to 4.20). There was no association between physical activity and pulmonary embolism (P=0.53 for trend). Conclusions Physical inactivity is associated with incident pulmonary embolism in women. Interventions that decrease time sitting could lower the risk of pulmonary embolism. Footnotes * The Nurses’ Health Study is coordinated at the Channing Laboratory, Brigham and Women’s Hospital, Boston, MA. We acknowledge the dedication and hard work of all of the Nurses’ Health Study staff, especially Gary Chase, Karen Corsano, Betsy Frost-Hawes, Barbara Egan, and of course the nurses themselves. * Contributors: CK conceived the study, obtained funding, collected the data, planned the analysis, drafted and critically revised the manuscript, and approved the final version for publication. RV and CAC conceived the study, obtained funding, planned and performed the statistical analysis, critically revised the manuscript, and approved the final version for publication. SZG and ER conceived the study, obtained funding, critically revised the manuscript, and approved the final version for publication. CK, RV, and CAC are guarantors. * Funding: This study was funded by the National Institute on Aging, National Institutes of Health, Bethesda, MD (R21AG031079, P01CA87969, and R01HL034594). The funding source had no role in design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript. * Competing interest: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
* Ethical approval: This study was approved by the human research committee of Partners HealthCare.
* Data sharing: Requests for access to data, statistical code, questionnaires, and technical processes may be made by contacting the corresponding author at ckabrhel@partners.org.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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Physical inactivity and idiopathic pulmonary embolism in women: prospective study -- Kabrhel et al. 343 -- bmj.com: "- Enviado mediante la barra Google"



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Actualidad Ultimas noticias - JANOes y agencias - El sedentarismo aumenta el riesgo de embolia pulmonar en mujeres - JANO.es - ELSEVIER: "NEUMOLOGÍA
El sedentarismo aumenta el riesgo de embolia pulmonar en mujeres

JANO.es y agencias · 07 Julio 2011 13:18

Un estudio concluye que el riesgo de embolia pulmonar es dos veces más alto en mujeres que pasan mucho tiempo sentadas (más de 41 horas por semana fuera del horario laboral).

Las mujeres que permanecen sentadas durante largos períodos de tiempo tienen multiplican por tres las posibilidades de desarrollar embolias en los pulmones, según un estudio publicado en el último número de la revista británica British Medical Journal.

Este estudio es el primero en probar que un estilo de vida sedentario aumenta el riesgo de embolia pulmonar, una causa común de afección cardíaca. Además, el estudio añade que, aunque el riesgo equivale solo a siete casos más por 10.000 personas al año y está ligeramente por encima del de las usuarias de anticonceptivos orales y de los pasajeros de vuelos de larga distancia, los resultados podrían apuntar hacia mayores repercusiones para la salud.

La embolia pulmonar se desarrolla cuando la sangre coagulada, o parte de ella, llega a los pulmones desde las piernas a través del torrente sanguíneo. Los síntomas incluyen dificultad respiratoria, dolor en el pecho y tos. Aunque otros estudios han explorado la relación entre la actividad física y la embolia pulmonar, existían muy pocos datos que describan esta conexión.

El doctor Christopher Kabrhel y sus colaboradores estudiaron a 69.950 enfermeras durante 18 años detallando información sobre su estilo de vida a través de cuestionarios bianuales. Descubrieron que el riesgo de embolia pulmonar es dos veces más alto en mujeres que pasaban mucho tiempo sentadas (más de 41 horas por semana fuera del horario laboral) en comparación con el de las mujeres que permanecían sentadas períodos más cortos (menos de 10 horas semanales fuera del trabajo).

Los resultados fueron concluyentes tras tener en cuenta factores como la edad, el índice de masa corporal y el tabaquismo, añadiendo a la evidencia que el sedentarismo es la causa principal de esta condición. El estudio señala que la escasa actividad física está relacionada con afecciones cardíacas e hipertensión y podría suponer uno de los mecanismos ocultos que vinculan la enfermedad arterial y la venosa.

Los autores concluyen que el sedentarismo está asociado a la ocurrencia de embolias pulmonares en mujeres y sugiere que las campañas públicas de salud que desaconsejan el sedentarismo podrían reducir los casos de embolia pulmonar.

En el editorial que acompaña el estudio, investigadores canadienses afirman que este 'refuerza la idea de que el sedentarismo prolongado aumenta los casos de enfermedad tromboembólica venosa y muestra qué actos cotidianos la favorecen'. Por último, el estudio apoya indirectamente la práctica de intervenciones preventivas a aquellas personas que padezcan inmovilidad prolongada.


British Medical Journal (2011); doi: 10.1136/bmj.d3867
Physical inactivity and idiopathic pulmonary embolism in women: prospective study -- Kabrhel et al. 343 -- bmj.com: "- Enviado mediante la barra Google"

British Medical Journal
bmj.com: "- Enviado mediante la barra Google"

- Enviado mediante la barra Google"