Lind Lars, Zethelius Björn, Byberg Liisa
Department of Medical Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Sciences/Geriatrics, Faculty of Medicine, Uppsala University, Uppsala, Sweden.
PLoS One. 2022 Jun 3;17(6):e0269402. doi: 10.1371/journal.pone.0269402. eCollection 2022.
Self-reported leisure-time physical activity (PA) has previously been linked to risk of cardiovascular disease (CVD). We now aim to investigate the strength of associations between PA and different CVDs and how the risk varies with age.
PA and traditional CV risk factors assessed by a questionnaire on a four-level scale in 2,175 men at age 50 years in the ULSAM study. Examinations were thereafter repeated at ages 60, 70, and 77.
During 40 years follow-up, 883 individuals experienced a CVD (myocardial infarction, stroke, or heart failure). Using data from all four examinations, a graded reduction in risk of incident CVD was seen with increasing PA (HR 0.84, 95%CI; 0.77-0.93, p = 0.001 for trend test). PA was related to myocardial infarction (HR 0.84, 95%CI; 0.74-0.95, 490 cases), heart failure (HR 0.79, 95%CI; 0.68-0.91, 356 cases), but only of borderline significance vs ischemic stroke (HR 0.85, 95%CI; 0.73-1.00, 315 cases) when the CVDs were analyzed separately. Adjusting for traditional CV risk factors attenuated all relationships between PA and incident CVD, and PA did not improve discrimination of CVD when added on top of risk factors. When 10-year risk was calculated from each examination, age 70 was the time-point when PA was most closely related to incident CVD.
Leisure-time physical activity is related to future CVD. This was most evident at 70 years of age. If a causal relationship between self-reported PA and CVD exists, this relationship might to a major degree be mediated by traditional risk factors.
既往研究表明，自我报告的休闲时间体力活动（PA）与心血管疾病（CVD）风险相关。我们旨在研究PA与不同类型CVD之间关联的强度，以及风险如何随年龄变化。
在ULSAM研究中，通过四级量表问卷对2175名50岁男性的PA和传统心血管风险因素进行评估。此后在60岁、70岁和77岁时重复进行检查。
在40年的随访期间，883人发生了CVD（心肌梗死、中风或心力衰竭）。使用所有四次检查的数据，随着PA增加，新发CVD风险呈分级降低（风险比[HR]0.84，95%置信区间[CI]：0.77 - 0.93，趋势检验p = 0.001）。PA与心肌梗死（HR 0.84，95%CI：0.74 - 0.95，490例）、心力衰竭（HR 0.79，95%CI：0.68 - 0.91，356例）相关，但单独分析CVD时，与缺血性中风的关联仅具有临界显著性（HR 0.85，95%CI：0.73 - 1.00，315例）。调整传统心血管风险因素后，PA与新发CVD之间的所有关系均减弱，且在风险因素基础上增加PA并未改善对CVD的鉴别能力。从每次检查计算10年风险时，70岁是PA与新发CVD关系最密切的时间点。
休闲时间体力活动与未来CVD相关。这在70岁时最为明显。如果自我报告的PA与CVD之间存在因果关系，这种关系可能在很大程度上由传统风险因素介导。
