Sjøl A, Thomsen K K, Schroll M, Andersen L B
Center of Preventive Medicine, Glostrup University Hospital, DK-2600 Glostrup, Denmark.
Scand J Med Sci Sports. 2003 Aug;13(4):224-30. doi: 10.1034/j.1600-0838.2003.00310.x.
Secular trends in AMI rates were analyzed in relation to physical activity levels. The population attributable risk of physical inactivity was calculated. Participants were randomly selected subjects from a suburb of Copenhagen, Denmark, screened during the years 1964-1991. Occupational physical activity and in leisure time were assessed 1964, 1974, 1976, 1982, 1987 and 1991 by self-administered questionnaire along with smoking habits and alcohol consumption. Blood pressure, weight, height and serum lipids were measured according to WHO-standards. Mortality data were obtained from death certificates, from hospital records or autopsies. Acute myocardial infarctions (AMI) 1964-1994 were included. 13.925 men and women aged 30, 40, 50 and 60 years, were drawn as random samples from a background population of 300.000 inhabitants. A cohort born in 1914 was examined in 1964 and 1974, a cohort born in 1936, was examined in 1976 and 1987; Monica (Monitoring trends and determinants in cardiovascular diseases) I cohort were examined in 1982 and 1987; MONICA II in 1986, and MONICA III in 1991. Mean physical activity level at leisure adjusted for age and sex increased over time (P < 0001). 25% of the men were sedentary, and more women reported a sedentary lifestyle than men. The overall trend was from 1964 to 1992 a decline in physical activity at work (P < 0001) in both gender and all age groups. The difference in AMI incidence rates between leisure time physical activity (LTPA) levels increased over time. No change was found in AMI rates comparing sedentary in different time periods. A remarkable decrease over time in the AMI incidence rate was found in physically active during leisure time. Population attributable risk (PAR) exceeded 40% in both genders in the late 1980s. In conclusion the difference in AMI rates between LTPA subgroups has increased over time. The low AMI rates observed among the most physically active reveal a substantial potential for the prevention of AMI through physical activity. A population attributable risk of more than 40% for physical inactivity suggests a potential for primary prevention through increased physical activity.
分析了急性心肌梗死（AMI）发病率的长期趋势与身体活动水平的关系。计算了身体不活动导致的人群归因风险。研究对象是从丹麦哥本哈根一个郊区随机选取的受试者，于1964年至1991年期间进行筛查。在1964年、1974年、1976年、1982年、1987年和1991年，通过自填问卷评估职业身体活动和休闲时间的身体活动，同时询问吸烟习惯和饮酒情况。按照世界卫生组织标准测量血压、体重、身高和血脂。死亡数据来自死亡证明、医院记录或尸检报告。纳入了1964年至1994年期间的急性心肌梗死病例。从30万居民的背景人群中随机抽取了13925名年龄在30岁、40岁、50岁和60岁的男性和女性。1914年出生的队列在1964年和1974年接受检查，1936年出生的队列在1976年和1987年接受检查；莫妮卡（心血管疾病监测趋势和决定因素）I队列在1982年和1987年接受检查；莫妮卡II队列在1986年接受检查，莫妮卡III队列在1991年接受检查。经年龄和性别调整后的休闲时间平均身体活动水平随时间增加（P<0.001）。25%的男性久坐不动，报告久坐生活方式的女性比男性更多。总体趋势是，从1964年到1992年，工作中的身体活动在男性和女性以及所有年龄组中均呈下降趋势（P<0.001）。休闲时间身体活动（LTPA）水平不同导致的AMI发病率差异随时间增加。比较不同时间段久坐人群的AMI发病率未发现变化。在休闲时间身体活跃的人群中，AMI发病率随时间显著下降。20世纪80年代末，男性和女性的人群归因风险（PAR）均超过40%。总之，LTPA亚组之间AMI发病率的差异随时间增加。在身体活动最活跃的人群中观察到的低AMI发病率表明，通过身体活动预防AMI具有很大潜力。身体不活动导致的人群归因风险超过40%，表明通过增加身体活动进行一级预防具有潜力。
