Department of Epidemiology and Public Health, University College London, United Kingdom.
Med Sci Sports Exerc. 2009 Jun;41(6):1206-11. doi: 10.1249/MSS.0b013e3181971247.
The biological mechanisms through which physical activity lowers the risk of cardiovascular disease (CVD) are incompletely understood. We examined the extent to which inflammatory/hemostatic factors (C-reactive protein and fibrinogen), metabolic factors (adiposity, total cholesterol, and HDL cholesterol), and hypertension mediate the association between physical activity and risk of CVD events.
Data were collected from a nationally representative sample of 7881 men and women that were linked to a patient-based database of CVD hospital admissions and deaths up to September 2006.
A total of 226 incident CVD events (64 fatal) occurred over an average follow-up of 7.2 yr. The risk of CVD decreased in relation to physical activity groups according to current recommendations (at least 30 min of moderate activity five times per week or vigorous activity three times per week). The lowest risks for CVD were seen in participants meeting the recommendations through undertaking vigorous activity (hazard ratio = 0.47, 95% CI = 0.22-0.99), although being physically active below the guidelines also conferred protection (hazard ratio = 0.57, 0.42-0.77). Biological risk factors collectively explained between 39.4% and 22.6% of the cardioprotective effects of moderate and vigorous physical activity, respectively. Inflammation and hypertension tended to explain the largest proportion of variance.
Participation in any physical activity, irrespective of meeting current guidelines, was associated with a lower risk of CVD. The inverse association between physical activity and CVD risk is partly mediated by biological risk factors.
体力活动降低心血管疾病（CVD）风险的生物学机制尚不完全清楚。我们研究了炎症/止血因子（C 反应蛋白和纤维蛋白原）、代谢因素（肥胖、总胆固醇和高密度脂蛋白胆固醇）和高血压在多大程度上调节体力活动与 CVD 事件风险之间的关联。
数据来自一个具有全国代表性的 7881 名男性和女性的样本，这些数据与 CVD 住院和死亡的基于患者的数据库相关联，截止到 2006 年 9 月。
在平均 7.2 年的随访期间，共发生 226 例 CVD 事件（64 例死亡）。根据现行建议，体力活动组的 CVD 风险呈下降趋势（每周至少进行 30 分钟的中度活动五次或每周三次剧烈活动）。通过进行剧烈活动符合建议的参与者的 CVD 风险最低（危险比=0.47，95%CI=0.22-0.99），尽管不符合指南的体力活动也具有保护作用（危险比=0.57，0.42-0.77）。生物风险因素共同解释了中度和剧烈体力活动分别对心脏的保护作用的 39.4%和 22.6%。炎症和高血压往往解释了最大比例的变异。
无论是否符合现行指南，参与任何体力活动都与 CVD 风险降低相关。体力活动与 CVD 风险之间的负相关部分是由生物风险因素介导的。
