中国一项长达 10 年的前瞻性队列研究：高血压患者的日常总体力活动与心血管疾病风险之间的关联。
The association between daily total physical activity and risk of cardiovascular disease among hypertensive patients: a 10-year prospective cohort study in China.
机构信息
Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
出版信息
BMC Public Health. 2021 Mar 16;21(1):517. doi: 10.1186/s12889-021-10551-z.
BACKGROUND
The effect of high levels of physical activity and relationship between daily total physical activity and the risk of cardiovascular disease (CVD) among hypertensive people were not clear. This study aimed to explore the optimum level of physical activity for CVD prevention.
METHODS
Data used in the present study was derived from the sub-study of China Kadoorie Biobank study (CKB) in Jiangsu province of China. The CKB was a prospective cohort study established during 2004-2008. At baseline, 53,259 participants aged 35-74 years were recruited for the CKB Jiangsu sub-study conducted in Wuzhong district of Suzhou City. Among those 53,259 participants, the 20,179 hypertensive individuals were our study population. The outcome events were cardiovascular diseases (CVDs), while the independent variable was total daily physical activity. The Cox proportional hazard models were introduced to investigate the association between total physical activity and CVDs, reporting as hazard ratios (HR) and 95% confidence intervals (CIs).
RESULTS
During a 10.1-year follow-up, 2419 CVD cases were identified. After adjustment for potential confounding factors, compared with participants at the lowest level of daily total physical activity, the hazard ratios for CVDs were 0.87 (95%CI: 0.79-0.97), 0.73 (95%CI: 0.65-0.83) and 0.75 (95%CI: 0.65-0.85) for participants within 2, 3 and 4 quartiles of physical activity. Such a negative association between total physical activity and CVDs were also observed among participants by gender and age-group, but within patients with stage 1 hypertension only. Moreover, the association of physical activity with CVDs was U-shape and the lowest HR (0.63, 95%CI: 0.54-0.74) was observed at 35.4 MET-h/d of total physical activity.
CONCLUSIONS
Total daily physical activity was negatively associated with CVDs among hypertensive adults in China, and this association was U-shape. It has some public health implications that community-based total physical activity intervention campaigns can be of help for CVDs prevention among hypertensive people in China.
背景
目前尚不清楚高水平体力活动对高血压患者的心血管疾病（CVD）的影响，以及日常总体力活动与 CVD 风险之间的关系。本研究旨在探讨预防 CVD 的最佳体力活动水平。
方法
本研究使用的数据来自中国慢性病前瞻性研究（CKB）江苏子研究的数据。CKB 是一项于 2004-2008 年期间建立的前瞻性队列研究。在基线时，招募了 53259 名年龄在 35-74 岁的参与者参加苏州吴中区的 CKB 江苏子研究。在这 53259 名参与者中，有 20179 名高血压患者为我们的研究人群。主要结局事件为心血管疾病（CVD），自变量为每日总体力活动。采用 Cox 比例风险模型探讨总体力活动与 CVD 之间的关系，报告为风险比（HR）和 95%置信区间（CI）。
结果
在 10.1 年的随访期间，共确定了 2419 例 CVD 病例。在调整了潜在混杂因素后，与每日总体力活动最低水平的参与者相比，体力活动处于第 2、3 和 4 四分位数的参与者发生 CVD 的风险比（HR）分别为 0.87（95%CI：0.79-0.97）、0.73（95%CI：0.65-0.83）和 0.75（95%CI：0.65-0.85）。这种总体力活动与 CVD 之间的负相关关系在按性别和年龄组划分的参与者中也观察到，但仅在 1 期高血压患者中观察到。此外，体力活动与 CVD 之间的关系呈 U 型，总体力活动为 35.4MET-h/d 时，HR 最低（0.63，95%CI：0.54-0.74）。
结论
在中国高血压成年人中，每日总体力活动与 CVD 呈负相关，且呈 U 型。这一发现具有一定的公共卫生意义，即基于社区的总体力活动干预活动可能有助于预防中国高血压人群的 CVD。
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