Rosenman R H, Bawol R D, Oscherwitz M
Ann N Y Acad Sci. 1977;301:627-41. doi: 10.1111/j.1749-6632.1977.tb38234.x.
A prospective study of coronary heart disease (CHD) was done in 2,635 volunteer male federal employees of postal, health, aerospace, and other agencies, aged 35--59 years at intake. The present analysis is concerned with 2,065 initially well whites, of whom 65 suffered clinical CHD during a 4 years of annual follow-up. The subjects differed markedly in their levels of habitual vocational physical activity, which is classified (1) by division into sedentary, moderate, and heavy activity groups, (2) by blue collar or white collar type of occupation, and (3) by calculated annual caloric expenditure for both vocational and non-vocational physical activities. Intake variables that were studied in relation to physical activity and the CHD incidence include age, serum cholesterol, systolic blood pressure, relative body weight, ECG abnormality, and cigarette smoking. Socioeconomic status (SES) is assessed by levels of education and income and by a combined SES categorization based upon both. Estimated composite CHD risk scores are based upon Framingham equations. The CHD risk factors, singly, as well as in a derived composite risk score, are higher for men with heavy compared to sedentary or moderate habitual physical activity. However, this is a spurious association found to be induced by differences of SES. Thus, when physical activity and SES are studied in a concurrent analysis, a higher CHD risk is significantly associated with lower SES status but not with differences of vocational physical activity. The CHD incidence in this population is studied in relationship both to the risk factors and physical activity by multivariate analysis, using the multiple logistic risk model. The incidence of CHD is significantly associated with age, serum cholesterol, systolic blood pressure, and cigarette smoking. It is not found to be associated with the type of occupation (i.e., blue or white collar), the level of reported habitual vocational physical activity, or the calculated total vocational plus nonvocational caloric expenditure in physical activity.
对2635名年龄在35至59岁之间、来自邮政、卫生、航空航天及其他机构的联邦男性雇员志愿者进行了一项冠心病（CHD）前瞻性研究。本次分析涉及2065名最初健康的白人，其中65人在4年的年度随访中患临床冠心病。受试者在习惯性职业体力活动水平上存在显著差异，该差异按以下方式分类：（1）按部门分为久坐、中度和重度活动组；（2）按职业类型分为蓝领或白领；（3）按职业和非职业体力活动计算的年度热量消耗。研究的与体力活动和冠心病发病率相关的数据包括年龄、血清胆固醇、收缩压、相对体重、心电图异常和吸烟情况。社会经济地位（SES）通过教育程度和收入水平以及基于两者的综合SES分类来评估。估计的综合冠心病风险评分基于弗雷明汉方程。与久坐或中度习惯性体力活动的男性相比，重度习惯性体力活动的男性的冠心病危险因素，无论是单独的还是综合得出的风险评分都更高。然而，这是一种由SES差异导致的虚假关联。因此，当在同时分析中研究体力活动和SES时，较高的冠心病风险与较低的SES状态显著相关，而与职业体力活动差异无关。使用多元逻辑风险模型，通过多变量分析研究了该人群中冠心病发病率与危险因素和体力活动之间的关系。冠心病发病率与年龄、血清胆固醇、收缩压和吸烟显著相关。未发现其与职业类型（即蓝领或白领）、报告的习惯性职业体力活动水平或计算得出的职业和非职业体力活动总热量消耗有关。
