Hummel Madeleine, Hantikainen Essi, Adami Hans-Olov, Ye Weimin, Bellocco Rino, Bonn Stephanie Erika, Lagerros Ylva Trolle
Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2:02, 171 76, Stockholm, Sweden.
Institute for Biomedicine, Affiliated to the University of Lübeck, Eurac Research, Bozen, Italy.
BMC Public Health. 2022 Mar 18;22(1):532. doi: 10.1186/s12889-022-12923-5.
Physical inactivity is a known risk factor for cardiovascular disease, but it is unclear if total and leisure time activity have different impact on the risk of myocardial infarction and stroke. In this cohort, we aimed to investigate the associations between both total and leisure time physical activity in detail, and the risks of myocardial infarction and stroke, both overall and for men and women separately.
We assessed the association between total and leisure time physical activity on the risk of myocardial infarction and stroke in a cohort of 31,580 men and women through record linkages from 1997-2016. We used Cox proportional hazards regression models to estimate hazard ratios (HR) with 95% confidence intervals (CI) based on detailed self-reported physical activity. In the adjusted analyses, we included age, sex, body mass index, level of education, cigarette smoking, alcohol consumption, diabetes, lipid disturbance and hypertension as potential confounders.
We identified 1,621 incident cases of myocardial infarction and 1,879 of stroke. Among men, there was an inverse association between leisure time activity and myocardial infarction in the third tertile compared to the first (HR: 0.78; 95% CI: 0.62-0.98; p for trend = 0.03). We also found an inverse association between leisure time activity and stroke in the third tertile compared to the first (HR: 0.78; 95% CI: 0.61-0.99; p for trend = 0.04), while the corresponding HR for stroke among women was 0.91; 95% CI: 0.74-1.13. We found no significant association between total physical activity and MI (HR: 1.12; 95% CI: 0.93-1.34) or stroke (HR: 1.14 95% CI: 0.94-1.39) comparing the highest to the lowest tertile in men. Women in the highest tertile of total physical activity had a 22% lower risk of myocardial infarction compared to the lowest tertile (HR: 0.78; 95% CI: 0.63-0.97; p for trend = 0.02) and an 8% (95% CI: 0.87-0.98) reduced risk of myocardial infarction with each 1 METh/day increase of leisure time physical activity.
Total physical activity was inversely associated with the risk of myocardial infarction in women, while leisure time physical activity was inversely associated with the risk of myocardial infarction and stroke in men.
缺乏身体活动是已知的心血管疾病风险因素，但总体活动量和休闲时间活动量对心肌梗死和中风风险的影响是否不同尚不清楚。在本队列研究中，我们旨在详细调查总体活动量和休闲时间活动量与心肌梗死和中风风险之间的关联，包括总体情况以及按男性和女性分别进行分析。
我们通过1997年至2016年的记录链接，评估了31580名男性和女性队列中总体活动量和休闲时间活动量与心肌梗死和中风风险之间的关联。我们使用Cox比例风险回归模型，根据详细的自我报告身体活动情况来估计风险比（HR）及95%置信区间（CI）。在调整分析中，我们纳入了年龄、性别、体重指数、教育程度、吸烟、饮酒、糖尿病、血脂紊乱和高血压作为潜在混杂因素。
我们确定了1621例心肌梗死和1879例中风的发病病例。在男性中，与第一三分位数相比，第三三分位数的休闲时间活动量与心肌梗死之间存在负相关（HR：0.78；95%CI：0.62 - 0.98；趋势p值 = 0.03）。我们还发现，与第一三分位数相比，第三三分位数的休闲时间活动量与中风之间存在负相关（HR：0.78；95%CI：0.61 - 0.99；趋势p值 = 0.04），而女性中风的相应HR为0.91；95%CI：0.74 - 1.13。在男性中，比较最高三分位数和最低三分位数时，我们发现总体身体活动量与心肌梗死（HR：1.12；95%CI：0.93 - 1.34）或中风（HR：1.14；95%CI：0.94 - 1.39）之间无显著关联。总体身体活动量处于最高三分位数的女性与最低三分位数相比，心肌梗死风险降低22%（HR：0.78；95%CI：0.63 - 0.97；趋势p值 = 0.02），且休闲时间身体活动量每增加1梅脱/天，心肌梗死风险降低8%（95%CI：0.87 - 0.98）。
总体身体活动量与女性心肌梗死风险呈负相关，而休闲时间身体活动量与男性心肌梗死和中风风险呈负相关。
