University of Texas Southwestern Medical School, Dallas, TX, USA.
Am Heart J. 2012 Jun;163(6):1037-40. doi: 10.1016/j.ahj.2012.03.005.
Physical activity (PA) participation differs by ethnicity, but contributing factors and cardiovascular (CV) outcomes related to these disparities are not well understood. We determined whether health beliefs regarding the benefit of PA contribute to ethnic differences in participation and assessed how these differences impact CV mortality.
The Dallas Heart Study is a longitudinal study of CV health. We assessed PA participation and health perceptions by questionnaire among 3,018 African American, Hispanic, and white men and women at baseline visit (2000-2002). Participant mortality was obtained through 2008 using the National Death Index.
African Americans (odds ratio 0.65, 95% CI 0.53-0.80) and Hispanics (odds ratio 0.34, 95% CI 0.26-0.45) were less likely to be physically active compared with whites even after accounting for income, educational status, age, sex, body mass index, diabetes, hypertension, and hyperlipidemia. Beliefs regarding the benefits of PA did not contribute to this disparity, as >94% of individuals felt PA was effective in preventing a heart attack across ethnicity. Physical activity participation was associated with a lower risk of all-cause mortality (hazard ratio [HR] 0.66, 95% CI 0.46-0.93) and CV disease death (HR 0.56, 95% CI 0.32-0.97) in multivariable adjusted models. Similar results were seen when restricting to African Americans (CV disease death, HR 0.57, 95% CI 0.31-1.05).
Ethnic minorities reported less PA participation, and lack of PA was associated with higher CV mortality overall and among African Americans. Health perception regarding the benefits of PA did not contribute to this difference, indicating there are other ethnic-specific factors contributing to physical inactivity that require future study.
体力活动（PA）的参与度因种族而异，但导致这些差异的相关因素和心血管（CV）结局尚不清楚。我们确定了与 PA 益处相关的健康信念是否有助于解释不同种族之间的参与差异，并评估了这些差异对 CV 死亡率的影响。
达拉斯心脏研究是一项关于 CV 健康的纵向研究。我们在基线访视时（2000-2002 年）通过问卷评估了 3018 名非裔美国人、西班牙裔和白人男性和女性的 PA 参与度和健康认知。通过国家死亡索引获取参与者的死亡率数据，截止日期为 2008 年。
与白人相比，非裔美国人（比值比 0.65，95%置信区间 0.53-0.80）和西班牙裔（比值比 0.34，95%置信区间 0.26-0.45）体力活动的可能性较低，即使在考虑了收入、教育程度、年龄、性别、体重指数、糖尿病、高血压和血脂异常等因素后也是如此。PA 益处的信念并没有导致这种差异，因为超过 94%的个体认为 PA 可以有效预防心脏病发作，无论其种族如何。PA 参与与全因死亡率（风险比 [HR] 0.66，95%置信区间 0.46-0.93）和 CV 疾病死亡（HR 0.56，95%置信区间 0.32-0.97）的风险降低相关，在多变量调整模型中。当限制在非裔美国人中时，也观察到类似的结果（CV 疾病死亡，HR 0.57，95%置信区间 0.31-1.05）。
少数民族报告的 PA 参与度较低，缺乏 PA 与总体 CV 死亡率以及非裔美国人的 CV 死亡率升高相关。与 PA 益处相关的健康认知并没有导致这种差异，这表明存在其他特定于种族的因素导致体力活动不足，需要进一步研究。
