Li Haiwei, Luo Liang, Zhang Jing, Zhao Yanhao, Cheng Peipei, Liu Dan, Guo Liwei
School of Physical Education, Shanxi Normal University, Taiyuan, China.
PLoS One. 2025 Aug 1;20(8):e0329232. doi: 10.1371/journal.pone.0329232. eCollection 2025.
Cardiovascular disease (CVD) was a global public health challenge. This study aimed to investigate the association between physical activity level (PAL) and CVD among middle-aged and older adults in China, to provide evidence to inform strategies for CVD prevention and management.
The diagnosis of CVD was based on self-reported physician-diagnosed heart disease or stroke, while PAL were classified using calculations derived from a structured questionnaire. Both datasets were obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS) survey. A multivariate logistic regression model was used for the primary correlation analysis. Additionally, restricted cubic spline (RCS) regression was employed to examine the potential nonlinear association between PAL and CVD.
The final analysis included 9,015 participants, 1,069 of whom were diagnosed with CVD, yielding a prevalence of 11.86%. After adjusting for all covariates, the multivariate-adjusted odds ratios (ORs) for the moderate PAL group (600-3000 MET-minutes/week) and the high PAL group (>3000 MET-minutes/week) were 0.79 (95% CI: 0.64-0.97) and 0.72 (95% CI: 0.60-0.87), respectively, compared to the low PAL group (<600 MET-minutes/week). Furthermore, restricted cubic spline analysis revealed a significant linear relationship between PAL and CVD (nonlinear P > 0.05), indicating that the OR for CVD decreased with higher levels of PAL.
This study revealed a negative correlation between PAL and the prevalence of CVD. Furthermore, our findings suggested that middle-aged and older adults should maintain moderate to high levels of physical activity, as this was associated with a lower risk of CVD.
心血管疾病（CVD）是一项全球性的公共卫生挑战。本研究旨在调查中国中老年人群身体活动水平（PAL）与心血管疾病之间的关联，为心血管疾病预防和管理策略提供依据。
心血管疾病的诊断基于自我报告的医生诊断的心脏病或中风，而身体活动水平则通过结构化问卷得出的计算结果进行分类。两个数据集均来自2018年中国健康与养老追踪调查（CHARLS）。主要相关性分析采用多变量逻辑回归模型。此外，使用受限立方样条（RCS）回归来检验身体活动水平与心血管疾病之间潜在的非线性关联。
最终分析纳入9015名参与者，其中1069人被诊断患有心血管疾病，患病率为11.86%。在对所有协变量进行调整后，与低身体活动水平组（<600代谢当量-分钟/周）相比，中等身体活动水平组（600 - 3000代谢当量-分钟/周）和高身体活动水平组（>3000代谢当量-分钟/周）的多变量调整比值比（OR）分别为0.79（95%置信区间：0.64 - 0.97）和0.72（95%置信区间：0.60 - 0.87）。此外，受限立方样条分析显示身体活动水平与心血管疾病之间存在显著的线性关系（非线性P>0.05），表明心血管疾病的OR随着身体活动水平的提高而降低。
本研究揭示了身体活动水平与心血管疾病患病率之间存在负相关。此外，我们的研究结果表明，中老年人群应保持中等至高身体活动水平，因为这与较低的心血管疾病风险相关。
