Ludwig Vera M, Bayley Adam, Cook Derek G, Stahl Daniel, Treasure Janet L, Asthworth Mark, Greenough Anne, Winkley Kirsty, Bornstein Stefan R, Ismail Khalida
Department of Medicine III, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
BMJ Open. 2018 Apr 12;8(4):e020942. doi: 10.1136/bmjopen-2017-020942.
Depressive symptoms are common but rarely considered a risk factor for unhealthy lifestyles associated with cardiovascular disease (CVD). This study investigates whether depressive symptoms are associated with reduced physical activity (PA) in individuals at high risk of developing CVD.
Secondary analysis of the cross-sectional baseline data from a randomised controlled trial of an intensive lifestyle intervention.
135 primary care practices in South London, UK.
1742 adults, 49-74 years, 86% male at high (≥20%) risk of developing CVD in the next 10 years as defined via QRISK2 score.
The main explanatory variable was depressive symptoms measured via the Patient Health Questionnaire-9 (PHQ-9). The main outcome was daily step count measured with an accelerometer (ActiGraph GT3X) stratified by weekdays and weekend days.
The median daily step count of the total sample was 6151 (IQR 3510) with significant differences (P<0.001) in mean daily step count between participants with low (PHQ-9 score: 0-4), mild (PHQ-9 score: 5-9) and moderate to severe depressive symptoms (PHQ-9 score: ≥10). Controlling for age, gender, ethnicity, education level, body mass index (BMI), smoking, consumption of alcohol, day of the week and season, individuals with mild depressive symptoms and those with moderate to severe depressive symptoms walked 13.3% (95% CI 18.8% to 7.9%) and 15.6% (95% CI 23.7% to 6.5%) less than non-depressed individuals, respectively. Furthermore, male gender, white ethnicity, higher education level, lower BMI, non-smoking, moderate alcohol intake, weekdays and summer season were independently associated with higher step count.
People at high risk of CVD with depressive symptoms have lower levels of PA.
ISRCTN84864870; Pre-results.
抑郁症状很常见，但很少被视为与心血管疾病（CVD）相关的不健康生活方式的风险因素。本研究调查抑郁症状是否与CVD高风险个体的体力活动（PA）减少有关。
对强化生活方式干预随机对照试验的横断面基线数据进行二次分析。
英国伦敦南部的135家初级保健机构。
1742名49 - 74岁的成年人，根据QRISK2评分，86%为男性，未来10年发生CVD的风险高（≥20%）。
主要解释变量是通过患者健康问卷-9（PHQ-9）测量的抑郁症状。主要结局是用加速度计（ActiGraph GT3X）测量的每日步数，按工作日和周末进行分层。
总样本的每日步数中位数为6151（四分位距3510），抑郁症状低（PHQ-9评分：0 - 4）、轻度（PHQ-9评分：5 - 9）和中度至重度（PHQ-9评分：≥10）的参与者之间的平均每日步数存在显著差异（P<0.001）。在控制年龄、性别、种族、教育水平、体重指数（BMI）、吸烟、饮酒、星期几和季节后，轻度抑郁症状个体和中度至重度抑郁症状个体分别比非抑郁个体少走13.3%（95%可信区间18.8%至7.9%）和15.6%（95%可信区间23.7%至6.5%）。此外，男性、白人种族、较高教育水平、较低BMI、不吸烟、适度饮酒、工作日和夏季与较高的步数独立相关。
有抑郁症状的CVD高风险人群的PA水平较低。
ISRCTN84864870；预结果。
