Holtermann Andreas, Mortensen Ole Steen, Burr Hermann, Søgaard Karen, Gyntelberg Finn, Suadicani Poul
National Research Centre for the Working Environment, Copenhagen, Denmark.
Scand J Work Environ Health. 2009 Dec;35(6):466-74. doi: 10.5271/sjweh.1357. Epub 2009 Oct 21.
Our aim was to test the hypothesis that a high level of physical activity during leisure time increases the risk of ischemic heart disease (IHD) mortality among men with high physical work demands.
We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 caucasian, male workers aged 40-59 years; 274 men with overt cardiovascular disease were excluded from the follow-up.
During the follow-up period, 591 men (11.9%) died from IHD. Cox analyses of men with low (N=1236), medium (N=2651), and high (N=858) physical work demands showed that those with high demands had a higher risk of IHD mortality compared to men with low demands [age-adjusted hazard ratio 1.51, 95% confidence interval (95% CI) 1.18-1.94]. In all three groups, men with a low level of physical activity during leisure time had a higher risk of IHD than men with a medium or high level. Overall, the age-adjusted hazard ratio for IHD mortality associated with a high level of leisure time physical activity was 0.49 (95% CI 0.34-0.70). Among workers with high physical work demands, the hazard ratio for IHD mortality (adjusted for confounders) was 0.82 (95% CI 0.42-1.56) for a high level of leisure time physical activity and 0.62 (95% CI 0.40-0.97) for a moderate level.
We did not find support for the hypothesis that a high level of physical activity during leisure time increases the risk of IHD mortality among men with high physical work demands and with no pre-existing clinical cardiovascular disease. In contrast, moderate and high levels of activity during leisure time seemed to be protective against IHD mortality among people with medium and high physical activity at work.
我们旨在检验这样一个假设，即对于从事高强度体力工作的男性而言，休闲时间进行大量体育活动会增加缺血性心脏病（IHD）死亡风险。
我们对哥本哈根男性研究中的5249名年龄在40 - 59岁的白种男性工人进行了30年的随访；274名患有明显心血管疾病的男性被排除在随访之外。
在随访期间，591名男性（11.9%）死于缺血性心脏病。对体力工作需求低（N = 1236）、中等（N = 2651）和高（N = 858）的男性进行的Cox分析表明，与体力工作需求低的男性相比，需求高的男性缺血性心脏病死亡风险更高[年龄调整风险比1.51，95%置信区间（95%CI）1.18 - 1.94]。在所有三组中，休闲时间体育活动水平低的男性比中等或高水平的男性患缺血性心脏病的风险更高。总体而言，与高水平休闲时间体育活动相关的缺血性心脏病死亡的年龄调整风险比为0.49（95%CI 0.34 - 0.70）。在体力工作需求高的工人中，高水平休闲时间体育活动的缺血性心脏病死亡风险比（经混杂因素调整）为0.82（95%CI 0.42 - 1.56），中等水平为0.62（95%CI 0.40 - 0.97）。
对于从事高强度体力工作且无既往临床心血管疾病的男性，我们没有找到证据支持休闲时间进行大量体育活动会增加缺血性心脏病死亡风险这一假设。相反，休闲时间进行中等强度和高强度活动似乎对工作中体力活动水平中等和高的人群预防缺血性心脏病死亡具有保护作用。
