Department of Epidemiology and Biostatistics, School of Public Health Indiana University, Bloomington, IN
Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
J Am Heart Assoc. 2018 Jun 12;7(12):e008234. doi: 10.1161/JAHA.117.008234.
The inverse association between physical activity and cardiovascular disease (CVD) is well- established and has previously been shown in people with and without single CVD risk factors. We examined whether level of global cardiovascular risk, on the basis of the pooled cohort equation or Reynolds risk score, which include multiple risk factors, modified the physical activity-CVD association.
Participants in the prospective WHS (Women's Health Study; n=27 536) reported their leisure-time physical activity at study entry (1992-1995) and during follow-up through 2013. Participants were divided into 10-year cardiovascular risk groups on the basis of the pooled cohort equation and Reynolds risk score. The primary outcome was incident total CVD. The CVD hazard ratio for active (≥500 kcal/wk of physical activity) compared with inactive (<500 kcal/wk) individuals was 0.73 (95% confidence interval, 0.66-0.80) in multivariable models. This association was not modified by level of cardiovascular risk; physical activity was inversely associated with CVD within all pooled cohort equation and Reynolds risk score groups (=0.17 and =0.66 for interaction, respectively). When the joint association of physical activity and level of cardiovascular risk was examined, women with higher risk on the basis of either the pooled cohort equation or Reynolds risk score had higher CVD rates compared with those at low risk, regardless of physical activity. However, among women at both high and low risk, being physically active was associated with lower risk of CVD events.
In this large prospective cohort of women, level of global cardiovascular risk did not modify the inverse association between leisure-time physical activity and incident CVD. Thus, promoting physical activity is important in women at both low and high cardiovascular risk.
体力活动与心血管疾病（CVD）之间呈负相关，这一关系已得到充分证实，并且在有或没有单一 CVD 风险因素的人群中均得到了证实。我们研究了基于 pooled cohort equation 或 Reynolds risk score 的总体心血管风险水平是否会改变体力活动与 CVD 之间的关联，后者包含多种风险因素。
前瞻性 WHS（妇女健康研究；n=27536）的参与者在研究开始时（1992-1995 年）和随访期间（至 2013 年）报告了他们的休闲时间体力活动。参与者根据 pooled cohort equation 和 Reynolds risk score 被分为 10 年心血管风险组。主要结局是总 CVD 事件。在多变量模型中，与不活动（<500 kcal/wk）个体相比，活跃（≥500 kcal/wk）个体的 CVD 风险比为 0.73（95%置信区间，0.66-0.80）。这种关联不受心血管风险水平的影响；在所有 pooled cohort equation 和 Reynolds risk score 组中，体力活动与 CVD 呈负相关（交互项分别为 0.17 和 0.66）。当同时考虑体力活动和心血管风险水平的联合关联时，无论体力活动如何，基于 pooled cohort equation 或 Reynolds risk score 风险较高的女性的 CVD 发生率均高于风险较低的女性。然而，在高风险和低风险的女性中，体力活动与 CVD 事件风险降低相关。
在这项大型前瞻性女性队列研究中，总体心血管风险水平并未改变休闲时间体力活动与 CVD 事件之间的负相关关系。因此，在心血管风险低和高的女性中，促进体力活动都很重要。
