Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA.
J Phys Act Health. 2024 Aug 16;21(10):980-989. doi: 10.1123/jpah.2024-0019. Print 2024 Oct 1.
Recent statistics highlight cardiovascular diseases (CVD) as a major global cause of death. This review examines the methodological approaches and the main results of independent, stratified, and joint association of sedentary time (ST) and physical activity (PA) on CVD outcomes.
We searched PubMed, Embase, Web of Science, and Scopus for prospective cohorts that examined the independent, stratified, or joint associations of ST and PA with CVD outcomes. Independent associations were defined as analyses mutually adjusted for PA and ST. Stratified associations were considered when there was a reference group in each stratum of PA or ST, and joint associations were defined by a single reference group for all other combined categories of ST and PA levels.
Of 45 articles, 69% explored independent association of ST or PA on CVD outcomes, while 31% using a stratified/joint approach. Most studies used self-reports for ST and PA and focused on CVD mortality. Mutually adjusted analyses identified ST positively and PA inversely associated to CVD outcomes. Stratified studies showed higher ST's pronounced impact on CVD for lower PA levels. High PA mitigated but did not eliminate ST's negative impact. Joint analyses revealed highest CVD risk in those with both high ST and low PA, and elevated risk in various intermediate combinations.
Employing independent, stratified, and joint association approaches can yield distinct and complementary public health messages aimed at promoting cardiovascular health. Recommendations should aim to not only to encourage boosting PA levels, but also, concurrently decrease ST.
最近的统计数据强调了心血管疾病（CVD）是全球主要的死亡原因之一。本综述考察了独立、分层和联合评估久坐时间（ST）和体力活动（PA）与 CVD 结局之间关联的方法学方法和主要结果。
我们在 PubMed、Embase、Web of Science 和 Scopus 中搜索了前瞻性队列研究，这些研究考察了 ST 和 PA 与 CVD 结局之间的独立、分层和联合关联。独立关联被定义为相互调整 PA 和 ST 的分析。当 PA 或 ST 的每个分层都有参考组时，考虑分层关联；当所有其他 ST 和 PA 水平的组合类别都有一个单一的参考组时，定义联合关联。
在 45 篇文章中，69%的文章探索了 ST 或 PA 对 CVD 结局的独立关联，而 31%的文章采用了分层/联合方法。大多数研究使用自我报告来评估 ST 和 PA，并关注 CVD 死亡率。相互调整的分析确定 ST 与 CVD 结局呈正相关，PA 与 CVD 结局呈负相关。分层研究表明，对于较低的 PA 水平，ST 时间较长对 CVD 的影响更为明显。高 PA 可以减轻但不能消除 ST 的负面影响。联合分析显示，ST 时间长和 PA 水平低的人 CVD 风险最高，各种中间组合的风险也升高。
采用独立、分层和联合关联方法可以得出不同且互补的公共卫生信息，旨在促进心血管健康。建议不仅要鼓励提高 PA 水平，还要同时减少 ST。
