Gillum R F, Mussolino M E, Ingram D D
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
Am J Epidemiol. 1996 May 1;143(9):860-9. doi: 10.1093/oxfordjournals.aje.a008829.
To test the hypothesis that physical inactivity is associated with increased stroke risk in women and men, the authors analyzed data from a longitudinal cohort study with three follow-up data collection waves. In the Nation Health and Nutrition Examination Survey I (NHANES I) Epidemiologic Follow-up Study, 7,895 white persons and black persons aged 45-74 years were examined in 1971-1975 as part of NHANES I. Included in this analysis were 5,852 persons without a history of stroke (fatal and nonfatal) or missing data. The average follow-up was 11.6 years (maximum, 16.4 years). Incident stroke (fatal or nonfatal) was the main outcome measure. Events were ascertained from cause of death information coded from death certificates and from discharge diagnoses coded from hospital and nursing home records during the follow-up period (1971 through 1987). Participants were asked to characterize their level of habitual physical activity as low, moderate, of high. The relative risk for stroke was estimated by Cox proportional hazards regression analysis, comparing persons reporting low with those reporting high physical activity at baseline and persons in the upper with those in the lower tertile of resting pulse rate. There were 249 incident cases of stroke identified in white women, 270 in white men, and 104 in blacks. In white women aged 65-74 years, low nonrecreational activity was associated with an increased risk of stroke (relative risk = 1.82,95% confidence interval 1.10-3.02) after adjusting for the baseline risk factors of age, smoking, history of diabetes, history of heart disease, education, systolic blood pressure, serum total cholesterol, body mass index, and hemoglobin concentration. Similar associations were seen for men and for blacks and for low recreational activity in women. A higher resting pulse rate was associated with an increased risk of stroke in blacks but not in whites. A consistent association of reported low physical activity with an increased risk of stroke was observed in white women. Regular physical activity may be of benefit in preventing stroke in women as well as men.
为了验证身体活动不足与男性和女性中风风险增加相关这一假设，作者分析了一项纵向队列研究的数据，该研究有三次随访数据收集波次。在全国健康和营养检查调查I（NHANES I）流行病学随访研究中，1971 - 1975年对7895名年龄在45 - 74岁的白人和黑人进行了检查，作为NHANES I的一部分。本次分析纳入了5852名无中风病史（致命性和非致命性）或无缺失数据的人员。平均随访时间为11.6年（最长16.4年）。新发中风（致命性或非致命性）是主要的结局指标。通过死亡证明编码的死亡原因信息以及随访期间（1971年至1987年）医院和疗养院记录编码的出院诊断来确定事件。参与者被要求将其习惯性身体活动水平描述为低、中或高。通过Cox比例风险回归分析估计中风的相对风险，比较基线时报告低身体活动者与高身体活动者，以及静息脉搏率处于上三分位数者与下三分位数者。在白人女性中确定了新发中风249例，白人男性中270例，黑人中104例。在65 - 74岁的白人女性中，在调整了年龄、吸烟、糖尿病史、心脏病史、教育程度、收缩压、血清总胆固醇、体重指数和血红蛋白浓度等基线风险因素后，低非娱乐性活动与中风风险增加相关（相对风险 = 1.82，95%置信区间1.10 - 3.02）。男性、黑人和女性的低娱乐性活动也观察到类似的关联。较高的静息脉搏率与黑人中风风险增加相关，但与白人无关。在白人女性中观察到报告的低身体活动与中风风险增加之间存在一致的关联。规律的身体活动可能对预防女性和男性中风有益。
