Department of Internal Medicine, Cardiovascular Center, Seoul National University, Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Gyeonggi-Do, Seongnam-Si, Korea.
Department of Internal Medicine, Seoul National University, 101 Daehak-ro, Chong No Gu, Seoul, Korea.
Eur Heart J. 2019 Nov 14;40(43):3547-3555. doi: 10.1093/eurheartj/ehz564.
Physical activity has been shown to reduce mortality in a dose-response fashion. Current guidelines recommend 500-1000 metabolic equivalent task (MET)-min per week of regular physical activity. This study aimed to compare the impact of leisure-time physical activity on mortality in primary versus secondary cardiovascular prevention.
This study included a total of 131 558 and 310 240 subjects with and without cardiovascular disease (CVD), respectively, from a population-based cohort. Leisure-time physical activity was measured by self-report questionnaires. The study subjects were followed-up for a median of 5.9 years, and the main study outcome was all-cause mortality. There was an inverse relationship between the physical activity level and the mortality risk in both groups. The benefit in the secondary prevention group was shown to be greater than that in the primary prevention group: every 500 MET-min/week increase in physical activity resulted in a 14% and 7% risk reduction in mortality in the secondary and primary prevention groups, respectively (interaction P < 0.001). In addition, while individuals without CVD benefited the most between 1 and 500 MET-min/week of physical activity, the benefit in those with CVD continued above 500 - 1000 MET-min/week. The adjusted mortality risk of individuals with CVD who performed a high level of physical activity (≥1000 MET-min/week) was shown to be comparable to or lower than that of their counterparts without CVD.
Individuals with CVD may benefit from physical activity to a greater extent than do healthy subjects without CVD.
身体活动呈剂量反应式降低死亡率。目前的指南建议每周进行 500-1000 个代谢当量任务（MET）-min 的有规律身体活动。本研究旨在比较在一级和二级心血管预防中，休闲时间身体活动对死亡率的影响。
这项研究共纳入了分别来自人群基础队列的有和无心血管疾病（CVD）的 131558 名和 310240 名受试者。休闲时间身体活动通过自我报告问卷进行测量。研究对象的中位随访时间为 5.9 年，主要研究结局为全因死亡率。在两组中，身体活动水平与死亡率风险呈负相关。二级预防组的获益大于一级预防组：身体活动每增加 500 MET-min/周，二级和一级预防组的死亡率风险分别降低 14%和 7%（交互 P<0.001）。此外，虽然无 CVD 的个体在 1-500 MET-min/周的身体活动中获益最大，但在 500-1000 MET-min/周以上，获益仍持续存在。有 CVD 的个体进行高水平身体活动（≥1000 MET-min/周）的调整后死亡率风险与无 CVD 的个体相比，具有可比性或更低。
与无 CVD 的健康个体相比，CVD 个体可能从身体活动中获益更大。
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