Holtermann Andreas, Marott Jacob Louis, Gyntelberg Finn, Søgaard Karen, Mortensen Ole Steen, Prescott Eva, Schnohr Peter
National Research Centre for the Working Environment, Lerso Parkallé 105, DK-2100 Copenhagen, Denmark.
Scand J Work Environ Health. 2016 Jul 1;42(4):291-8. doi: 10.5271/sjweh.3563. Epub 2016 Apr 19.
This study aimed to investigate whether workers with the combination of high occupational physical activity (OPA) and low cardiorespiratory fitness have an increased risk of cardiovascular disease (CVD) and all-cause mortality.
Using multivariable Cox proportional hazards regression, we analyzed 2190 males and 2534 females from the Copenhagen City Heart Study, aged 20-67 years and with no known CVD at study entry in 1991-1994, for the risk of CVD and all-cause mortality from independent, stratified and combinations of self-reported OPA (ie, low, moderate and high) and cardiorespiratory fitness (low, same and higher as peers) at baseline.
During a median follow-up of 18.5 years, 257 and 852 individuals died from CVD and any cause, respectively. In the fully-adjusted model, an increased risk for CVD mortality was found for those with low compared to high self-reported cardiorespiratory fitness [hazard ratio (HR) 2.17, 95% confidence interval (95% CI) 1.40-3.38), for those with high compared to low OPA (HR 1.45, 95% CI 1.05-2.00), and for those with high compared to low OPA within the strata of low self-reported cardiorespiratory fitness (HR 2.83, 95% CI 1.24-6.46). Moreover, those with the combination of high OPA and low self-reported cardiorespiratory fitness had an increased risk for CVD mortality compared to those with the combination of low OPA and high self-reported cardiorespiratory fitness (HR 6.22, 95% CI 2.67-14.49). Rather similar, but lower risk estimates were found for all-cause mortality.
These findings may have important implications for CVD prevention among workers with excessive cardiovascular strain at work.
本研究旨在调查职业体力活动（OPA）高且心肺适能低的工人患心血管疾病（CVD）和全因死亡率增加的风险。
我们使用多变量Cox比例风险回归分析了哥本哈根城市心脏研究中的2190名男性和2534名女性，这些人年龄在20 - 67岁之间，于1991 - 1994年研究开始时无已知的CVD，分析其在基线时自我报告的OPA（即低、中、高）和心肺适能（低、与同龄人相同、高于同龄人）的独立、分层及组合情况下患CVD和全因死亡率的风险。
在中位随访18.5年期间，分别有257人和852人死于CVD和任何原因。在完全调整模型中，自我报告的心肺适能低的人与高的人相比，CVD死亡率风险增加[风险比（HR）2.17，95%置信区间（95%CI）1.40 - 3.38]；OPA高的人与低的人相比（HR 1.45，95%CI 1.05 - 2.00）；在自我报告的心肺适能低的分层中，OPA高的人与低的人相比（HR 2.83，95%CI 1.24 - 6.46）。此外，与OPA低且自我报告的心肺适能高的人相比，OPA高且自我报告的心肺适能低的人CVD死亡率风险增加（HR 6.22，95%CI 2.67 - 14.49）。全因死亡率的风险估计较为相似，但较低。
这些发现可能对工作中心血管压力过大的工人的CVD预防具有重要意义。
