Laukkanen Jari A, Rauramaa Rainer, Kurl Sudhir
School of Public Health and Clinical Nutrition, Research Institute of Public Health, University of Kuopio, Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
Eur J Cardiovasc Prev Rehabil. 2008 Jun;15(3):285-92. doi: 10.1097/HJR.0b013e3282f37a33.
No data exist on exercise workload combined with European Systematic Coronary Risk Evaluation (SCORE) with respect to death from cardiovascular diseases and other causes. We therefore investigated the prognostic significance of risk scores and exercise capacity with respect to cardiovascular diseases.
A population-based follow-up study.
Exercise workload was measured by exercise test with an electrically braked cycle ergometer. The study is based on a random population-based sample of 1639 men (42-60 years) without history of type II diabetes or atherosclerotic cardiovascular disease including coronary heart disease, stroke or claudication.
During an average follow-up of 16 years, a total of 304 overall deaths and 116 cardiovascular deaths occurred. Relative risk (RR) was 2.50 [95% confidence intervals (CI): 1.71-3.68, P<0.001] for all-cause death and 2.04 (95% CI: 1.14-3.65, P=0.016) for cardiovascular death among men with exercise capacity less than 162 W as compared with those with exercise capacity over 230 W, after adjustment for risk factors. Independent predictors for all-cause death were European SCORE (for 1% increment, RR: 1.15, 95% CI: 1.10-1.20, P<0.001), exercise workload (for 20 W increment, RR: 0.86, 95% CI: 0.82-0.91, P<0.001), C-reactive protein and alcohol consumption, when adjusted for serum high-density lipoprotein, body mass index, family history of coronary heart disease, exercise-induced ST changes and the use of medications for hypertension, dyslipidemia or aspirin.
Low exercise workload predicts an especially high risk for death from cardiovascular and any other cause when combined with high risk SCORE.
关于运动负荷与欧洲系统性冠状动脉风险评估（SCORE）相结合对心血管疾病及其他原因导致的死亡影响，尚无相关数据。因此，我们调查了风险评分和运动能力对心血管疾病的预后意义。
一项基于人群的随访研究。
通过电动刹车的自行车测力计进行运动测试来测量运动负荷。该研究基于一个随机抽取的1639名男性（42 - 60岁）的人群样本，这些男性无II型糖尿病或动脉粥样硬化性心血管疾病史，包括冠心病、中风或间歇性跛行。
在平均16年的随访期间，共发生304例全因死亡和116例心血管死亡。与运动能力超过230瓦的男性相比，运动能力低于162瓦的男性全因死亡的相对风险（RR）为2.50[95%置信区间（CI）：1.71 - 3.68，P < 0.001]，心血管死亡的相对风险为2.04（95%CI：1.14 - 3.65，P = 0.016），在对风险因素进行调整后。在对血清高密度脂蛋白、体重指数、冠心病家族史、运动诱发的ST段改变以及高血压、血脂异常或阿司匹林用药情况进行调整后，全因死亡的独立预测因素为欧洲SCORE（每增加1%，RR：1.15，95%CI：1.10 - 1.20，P < 0.001）、运动负荷（每增加20瓦，RR：0.86，95%CI：0.82 - 0.91，P < 0.001）、C反应蛋白和饮酒量。
低运动负荷与高风险SCORE相结合时，预示着心血管疾病及任何其他原因导致死亡的风险特别高。
