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身体活动可降低冠心病成人的全因和心脑血管死亡率。

Physical activity lowers all-cause and cardio-cerebrovascular mortality in adults with coronary heart disease.

机构信息

Department of Geriatrics, Ningbo No.2 Hospital, Ningbo, Zhejiang 315000, PR China.

Science and Education Department, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nanning, Guangxi 530021, PR China.

出版信息

Int J Cardiol. 2024 Sep 1;410:132225. doi: 10.1016/j.ijcard.2024.132225. Epub 2024 May 29.

Abstract

BACKGROUND

The health outcomes and their adherence to guideline-based secondary prevention physical activity in US patients with coronary heart disease (CHD), together with the association between physical activity (PA) and mortality risk, were investigated.

METHODS

Data on CHD patients (aged 18 to 85 years) was acquired from the US National Health and Nutrition Examination Survey (NHANES) 1999-2018. The patients were divided into four groups according to the level and frequency of PA, namely, a) sedentary (n = 1178), b) moderate PA (moderate, n = 270), c) vigorous PA once or twice per week (vigorous ≤2×, n = 206), and d) vigorous PA three or more times per week (vigorous >2×, n = 598). Logistic analysis was used to determine the relationship between PA and all-cause or cardio-cerebrovascular mortality in CHD patients.

RESULTS

A total of 2252 patients with CHD were enrolled, of whom 47.69% reported adequate PA. During the investigation, there were 296 (13.14%) cardio-cerebrovascular and 724 (32.15%) all-cause deaths. The incidence of all-cause or cardio-cerebrovascular death was lowest in the vigorous ≤2× group. Patients who undertook vigorous PA ≤ 2× showed the lowest risk of all-cause (odds ratio 0.32; 95% confidence interval 0.22-0.47; P < 0.01) or cardio-cerebrovascular death (odds ratio 0.43; 95% confidence interval 0.25-0.73; P < 0.01) relative to those in the sedentary group. More frequent vigorous PA did not lead to improved benefits.

CONCLUSIONS

Vigorous PA once or twice per week was more effective for reducing all-cause and cardio-cerebrovascular mortality compared with patients performing no or a moderate level of PA in US adults with CHD.

摘要

背景

本研究旨在探讨美国冠心病(CHD)患者的健康结局及其对基于指南的二级预防体力活动的依从性,以及体力活动(PA)与死亡风险之间的关系。

方法

本研究的数据来自于美国国家健康和营养调查(NHANES)1999-2018 年的数据,共纳入了 18 至 85 岁的 CHD 患者。根据 PA 的水平和频率,患者被分为四组:a)久坐组(n=1178);b)中强度 PA 组(中强度,n=270);c)每周进行 1-2 次剧烈 PA 组(剧烈,≤2×,n=206);d)每周进行 3 次或以上剧烈 PA 组(剧烈,>2×,n=598)。采用 logistic 分析确定 PA 与 CHD 患者全因或心脑血管死亡的关系。

结果

共纳入 2252 例 CHD 患者,其中 47.69%的患者报告体力活动充足。在研究期间,有 296 例(13.14%)发生心脑血管死亡,724 例(32.15%)发生全因死亡。在剧烈,≤2×组中,全因或心脑血管死亡的发生率最低。与久坐组相比,每周进行 1-2 次剧烈 PA 的患者发生全因(比值比 0.32;95%置信区间 0.22-0.47;P<0.01)或心脑血管死亡(比值比 0.43;95%置信区间 0.25-0.73;P<0.01)的风险最低。更频繁的剧烈 PA 并不能带来更好的效果。

结论

与不运动或运动强度较低的 CHD 美国成年人相比,每周进行 1-2 次剧烈 PA 更能有效降低全因和心脑血管死亡风险。

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