Li Wei, Luo Wei, Guo Shuai, Yang Yunxiao, Yi Jiayi, Li Chen, Shen Geng, Gao Hai
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
BMJ Open Sport Exerc Med. 2025 Jul 1;11(3):e002358. doi: 10.1136/bmjsem-2024-002358. eCollection 2025.
This study aimed to estimate the combined effects of long-term fine particulate matter (PM) exposure and physical activity (PA) on cardiovascular disease (CVD) risk and to assess whether the cardiovascular benefits of PA outweigh the potential adverse effects of PM exposure.
Data were obtained from the China Health and Retirement Longitudinal Study and the ChinaHighAirPollutants datasets. Cox proportional hazards models were used to assess the independent and combined effects of PA and long-term PM exposure on CVD. Interaction analyses were conducted to determine whether the cardiovascular effects of PM or PA were modified by each other.
PA was negatively associated with CVD risk. Each IQR increase in PA significantly reduced the risk of CVD by 10% (HR=0.90, 95% CI 0.83 to 0.98). While PM exposure was positively associated with CVD, a 10 μg/m increase in PM significantly increased 5% risk of CVD (HR=1.05, 95% CI 1.00 to 1.09). Compared with participants with high PA and low PM exposure, those with low PA and high PM exposure had the highest risk of CVD (HR=1.56, 95% CI 1.15 to 2.13). Long-term PM exposure increased the risk of CVD in participants with low and moderate PAs, but not high PA.
The beneficial effects of high levels of PA may mitigate the detrimental effects of PM exposure, indicating that PA is an effective strategy for reducing the risk of CVD, even among individuals living in areas with elevated PM concentrations.
本研究旨在评估长期暴露于细颗粒物（PM）和身体活动（PA）对心血管疾病（CVD）风险的综合影响，并评估PA对心血管的益处是否超过PM暴露的潜在不利影响。
数据来自中国健康与养老追踪调查（China Health and Retirement Longitudinal Study）和中国高空气污染物数据集（ChinaHighAirPollutants datasets）。采用Cox比例风险模型评估PA和长期PM暴露对CVD的独立和综合影响。进行交互分析以确定PM或PA对心血管的影响是否相互改变。
PA与CVD风险呈负相关。PA每增加一个四分位数间距（IQR），CVD风险显著降低10%（风险比[HR]=0.90，95%置信区间[CI]为0.83至0.98）。虽然PM暴露与CVD呈正相关，但PM每增加10μg/m³，CVD风险显著增加5%（HR=1.05，95%CI为1.00至1.09）。与高PA和低PM暴露的参与者相比，低PA和高PM暴露的参与者患CVD的风险最高（HR=1.56，95%CI为1.15至2.13）。长期PM暴露增加了低PA和中等PA参与者患CVD的风险，但高PA参与者未增加。
高水平PA的有益作用可能减轻PM暴露的有害影响，表明PA是降低CVD风险的有效策略，即使在PM浓度升高地区的个体中也是如此。
