Fletcher G F
Emory University School of Medicine, Georgia.
Health Rep. 1994;6(1):106-10.
Lifestyle and behaviour modifications that include exercise are effective in the prevention of cardiovascular disease and stroke. The benefits are manifested largely through the role that exercise plays in the control of certain modifiable risk factors, such as control blood lipid abnormalities, diabetes and obesity. Exercise also adds an independent effect in the lowering of blood pressure in certain hypertensive groups, thus favourably modifying a major risk factor for stroke. The Honolulu Heart Program, a 22 year follow-up of 5,362 men (aged 58 to 68) revealed that physical activity was protective against "clot caused" stroke only in nonsmokers. This study also revealed that inactive and partially active men compared with those who were active had fourfold increases in intracerebral hemorrhage and threefold increases in subarachnoid hemorrhage. The Framingham study suggested a relationship between sedentary work and stroke although this was not statistically significant. In a 16-year follow-up of 3,263 cargo handlers the death rate from stroke was similar to that of more sedentary people. However, the mortality was threefold higher among those who were sedentary and had higher systolic blood pressure. The exercise employed in prevention can be mild to moderate in intensity and may be of the type experienced in occupational, recreational and leisure time activity. Clinical data reveal that aerobic exercise equal to or greater than 50% of one's maximum capacity can be "protective" in cardiovascular disease.
包括运动在内的生活方式和行为改变对预防心血管疾病和中风有效。这些益处主要通过运动在控制某些可改变的风险因素中所起的作用体现出来，比如控制血脂异常、糖尿病和肥胖。运动在某些高血压人群中对降低血压也有独立作用，从而有利地改变中风的一个主要风险因素。檀香山心脏项目对5362名男性（年龄在58至68岁之间）进行了22年的随访，结果显示体育活动仅对不吸烟者预防“血栓导致的”中风有保护作用。这项研究还显示，与活跃男性相比，不活跃和部分活跃的男性脑出血增加了四倍，蛛网膜下腔出血增加了三倍。弗雷明汉姆研究表明久坐工作与中风之间存在关联，尽管这在统计学上并不显著。在对3263名货物搬运工进行的16年随访中，中风死亡率与久坐人群相似。然而，在久坐且收缩压较高的人群中，死亡率高出三倍。预防中采用的运动强度可以是轻度到中度，可能是职业、娱乐和休闲活动中常见的类型。临床数据显示，等于或大于个人最大能力50%的有氧运动对心血管疾病可能具有“保护作用”。
