Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain.
Mayo Clin Proc. 2024 Apr;99(4):564-577. doi: 10.1016/j.mayocp.2023.05.028. Epub 2023 Sep 9.
To assess the association of physical activity (PA) with cause-specific cardiovascular disease (CVD) mortality among people with preexisting CVD and to analyze the relationship of PA with CVD-related mortality in people without CVD as well as the association of PA with nonspecific CVD mortality in both populations.
Of the total participants in the 1997 through 2018 US National Health Interview Survey waves, 87,959 adults with CVD and 527,185 without CVD were included. Leisure-time PA was self-reported; based on frequency and duration, minutes per week in PA were calculated and subsequently classified into: (1) none: 0 min/wk, (2) insufficient: 1 to 149.9 min/wk, (3) recommended: 150 to 300 min/wk, and (4) additional: more than 300 min/wk. Mortality data were obtained through link to records from the National Death Index. Statistical analyses were performed with Cox regression adjusted for potential confounders.
During a mean follow-up of 8.5 years, 12,893 participants with CVD, 9943 with coronary heart disease (CHD), and 843 with stroke died of CVD mortality, diseases of heart mortality, and cerebrovascular mortality, respectively. In fully adjusted models, compared with no PA, insufficient, recommended, and additional PA were associated with 25.9%, 37.1%, and 42.0% lower risk of diseases of heart mortality among people with prior CHD, respectively. Among people with stroke, recommended and additional PA was related to 30.7% and 59.3% lower risk of cerebrovascular mortality, respectively. The protective effect of PA on cause-specific CVD mortality was greater in people with CVD than in those without prior CVD. Moreover, PA was more markedly inversely associated with cause-specific CVD mortality than with nonspecific CVD mortality in people with CVD.
Physical activity was strongly associated with lower risk of CVD-, CHD-, and stroke-related mortality among people with a history of these specific diseases. Health care professionals should emphasize the importance of a physically active lifestyle in patients with CVD.
评估体力活动（PA）与既往患有 CVD 的人群中特定原因心血管疾病（CVD）死亡率之间的关联，并分析 PA 与无 CVD 人群中 CVD 相关死亡率的关系，以及 PA 与这两个人群中无特定原因 CVD 死亡率的关系。
在 1997 年至 2018 年期间的美国国家健康访谈调查中，共有 87959 名患有 CVD 的成年人和 527185 名没有 CVD 的成年人参与。PA 是通过自我报告的；根据频率和持续时间，计算每周的 PA 分钟数，并随后将其分为：（1）无：0 分钟/周，（2）不足：1 至 149.9 分钟/周，（3）推荐：150 至 300 分钟/周，和（4）额外：超过 300 分钟/周。通过与国家死亡指数记录的链接获得死亡率数据。使用 Cox 回归进行统计分析，调整了潜在的混杂因素。
在平均 8.5 年的随访期间，12893 名患有 CVD 的患者、9943 名患有冠心病（CHD）的患者和 843 名患有中风的患者分别死于 CVD 死亡率、心脏病死亡率和脑血管死亡率。在完全调整的模型中，与无 PA 相比，不足、推荐和额外的 PA 与既往 CHD 患者的心脏病死亡率风险分别降低 25.9%、37.1%和 42.0%相关。对于中风患者，推荐和额外的 PA 与 30.7%和 59.3%的脑血管死亡率风险降低相关。PA 对特定原因 CVD 死亡率的保护作用在患有 CVD 的人群中大于在没有既往 CVD 的人群中。此外，PA 与 CVD 患者的特定原因 CVD 死亡率的相关性比非特定原因 CVD 死亡率更为显著。
PA 与患有这些特定疾病的人群中 CVD、CHD 和中风相关死亡率的降低风险密切相关。医疗保健专业人员应强调积极生活方式对 CVD 患者的重要性。
