Wannamethee G, Shaper A G, Macfarlane P W
Department of Public Health and Primary Care, Royal Free Hospital School of Medicine, London, England.
Am J Epidemiol. 1993 Apr 1;137(7):735-48. doi: 10.1093/oxfordjournals.aje.a116734.
The relations between resting heart rate on electrocardiogram, usual physical activity, and risks of all noncardiovascular mortality, cancer mortality, and other noncardiovascular mortality were examined in 7,735 middle-aged British men drawn from general practices in 24 British towns. Subjects were examined and administered questionnaires in 1978-1980. During a follow-up period of 9.5 years (to December 1989), there were 334 deaths from noncardiovascular causes, including 225 cancer deaths. A strong positive association was seen between heart rate and all noncardiovascular mortality, cancer mortality, and other noncardiovascular mortality, even after adjustment for age, blood cholesterol, body mass index, heavy alcohol drinking, physical activity, preexisting ischemic heart disease, smoking, social class, and systolic blood pressure (p < 0.01). The relative risks in men with heart rates of > or = 90 beats/minute, in comparison with those with heart rates of < 60 beats/minute, were 2.33 (95% confidence interval (CI) 1.42-3.74) for total noncardiovascular mortality, 1.68 (95% CI 0.92-3.10) for cancer mortality, and 3.56 (95% CI 1.65-7.65) for mortality due to other noncardiovascular causes. The positive associations with cancer and all noncardiovascular mortality persisted even after further adjustment for lung function (forced expiratory volume in 1 second) and exclusion of men with underlying ill health and of deaths occurring within the first 5 years of follow-up. A significant inverse association with seen between physical activity and risk of cancer death, even after adjustment for the above factors and heart rate, with a significant reduction only in those engaged in high levels of usual physical activity (relative risk = 0.62, 95% CI 0.39-0.98). The data suggest that in middle-aged men, resting heart rate and physical activity are independent prognostic factors for cancer mortality.
在从英国24个城镇的普通诊所选取的7735名中年男性中，研究了心电图静息心率、日常身体活动与所有非心血管疾病死亡率、癌症死亡率及其他非心血管疾病死亡率之间的关系。在1978年至1980年期间对受试者进行了检查并发放了问卷。在9.5年的随访期（至1989年12月）内，有334例非心血管疾病死亡，其中包括225例癌症死亡。即使在对年龄、血胆固醇、体重指数、大量饮酒、身体活动、既往缺血性心脏病、吸烟、社会阶层和收缩压进行调整后，心率与所有非心血管疾病死亡率、癌症死亡率及其他非心血管疾病死亡率之间仍呈现出强烈的正相关（p<0.01）。静息心率≥90次/分钟的男性与静息心率<60次/分钟的男性相比，总非心血管疾病死亡率的相对风险为2.33（95%置信区间（CI）1.42 - 3.74），癌症死亡率的相对风险为1.68（95%CI 0.92 - 3.10），其他非心血管疾病导致的死亡率的相对风险为3.56（95%CI 1.65 - 7.65）。即使在进一步对肺功能（第1秒用力呼气量）进行调整并排除有潜在健康问题的男性以及随访前5年内发生的死亡病例后，与癌症和所有非心血管疾病死亡率的正相关仍然存在。即使在对上述因素和心率进行调整后，身体活动与癌症死亡风险之间仍呈现出显著的负相关，只有从事高水平日常身体活动的人群风险显著降低（相对风险 = 0.62，95%CI 0.39 - 0.98）。数据表明，在中年男性中，静息心率和身体活动是癌症死亡率的独立预后因素。
