Johansson S, Rosengren A, Tsipogianni A, Ulvenstam G, Wiklund I, Wilhelmsen L
Department of Medicine, Ostra Hospital, Göteborg, Sweden.
Eur Heart J. 1988 Nov;9 Suppl L:8-19. doi: 10.1093/eurheartj/9.suppl_l.8.
Physical activity at work and during leisure time were studied by using a questionnaire in a random sample of 7495 middle-aged men from the Primary Prevention Study in Göteborg and in 1273 able-bodied male patients with a first myocardial infarction, registered in the Infarction Register in the same city over the period 1968-84. Data on coronary risk factors and socio-economic factors were recorded in the population sample as were data on risk factors and known somatic predictors for prognosis in the infarction group. An inverse and graded association was found between leisure time physical activity and mean diastolic blood pressure, total cholesterol, body mass index, tobacco smoking, socio-economic status and mental stress in the random sample. During the approximate 12-year follow-up, low physical activity during leisure time, but not at work, was associated with an increased risk of coronary deaths and non-fatal infarctions in univariate analysis. Inactive subjects had twice the incidence of total coronary events (9.4%) as physically active contemporaries (4.2%). After controlling for major coronary risk factors, occupational class, diabetes, family history of coronary heart disease and mental stress in a multivariate logistic regression analysis, the association between leisure time physical activity and total coronary events disappeared. Physical activity at work and during leisure time estimated for the 12-month period preceding the first infarction was not associated with long-term prognosis after infarction. Infarction patients assessed to be in need of additional rehabilitation due to somatic restrictions, work-related factors and emotional instability, resumed work later and had a higher mortality and non-fatal recurrence rate during follow-up than patients not considered to require additional rehabilitation. Physical inactivity was not a risk factor for primary and secondary coronary events in this study. The inverse direction of the association between leisure time physical activity and coronary risk factors suggests that increased physical activity alters the risk factor profile in a favourable direction.
通过问卷调查，对哥德堡初级预防研究中的7495名中年男性随机样本以及1968 - 1984年期间在同一城市心肌梗死登记处登记的1273名身体健康的首次心肌梗死男性患者的工作和休闲时间的身体活动情况进行了研究。在总体样本中记录了冠状动脉危险因素和社会经济因素的数据，在梗死组中记录了危险因素和已知的躯体预后预测因素的数据。在随机样本中，发现休闲时间身体活动与平均舒张压、总胆固醇、体重指数、吸烟、社会经济地位和精神压力之间存在负向分级关联。在大约12年的随访期间，单因素分析显示，休闲时间身体活动少（而非工作时身体活动少）与冠状动脉死亡和非致命性梗死风险增加相关。不活动的受试者发生冠状动脉事件总数的发生率（9.4%）是身体活动的同龄人的两倍（4.2%）。在多因素逻辑回归分析中，在控制了主要冠状动脉危险因素、职业阶层、糖尿病、冠心病家族史和精神压力后，休闲时间身体活动与冠状动脉事件总数之间的关联消失。首次梗死前12个月期间评估的工作和休闲时间的身体活动与梗死后的长期预后无关。因躯体限制、工作相关因素和情绪不稳定而被评估需要额外康复的梗死患者，恢复工作较晚，随访期间的死亡率和非致命复发率高于不被认为需要额外康复的患者。在本研究中，身体不活动不是原发性和继发性冠状动脉事件的危险因素。休闲时间身体活动与冠状动脉危险因素之间关联的反向表明，增加身体活动可使危险因素状况朝有利方向改变。
