不运动比抽菸更容易引起心脏病


  【24drs.com】一篇新研究显示,对于30岁以上的澳洲女性,不运动比抽菸、肥胖、高血压更容易引起心脏病。
  
  澳洲昆士兰大学人类运动研究院运动体能活动暨健康研究中心Wendy J. Brown博士等人写道,促进与维持女性体力的方案应比现在获得更多公卫重视。
  
  这篇研究在线登载于5月8日英国运动医学期刊。
  
  之前的一篇研究中,全球10大疾病风险因素是将高血压列为首位,其次依序为抽菸和固体燃料引起的空气污染。
  
  不过,Brown博士等人假设,澳洲的情况和世界上其它地方是不相同的,例如,澳洲并未燃烧那么多固体燃料,作者们也认为风险因素可能会随女性的年纪而有所改变。
  
  因此,他们针对澳洲已知的前4大风险因素:过重、抽菸、高血压、运动进行研究,以量化造成女性在各年龄阶段发生心脏病的变化。
  
  他们计算人群归因风险,这是一种用来定义特定人群之疾病比率的数学方式,如果曝露的某一特定风险因素消除时,则该风险会消失。
  
  他们是对「Australian Longitudinal Study on Women's Health」研究的32,154名参与者的4个风险因素之盛行率估计进行计算,该研究自1996年开始,长期追踪在1921-1926、1946-1951、1973-1978等年份出生之妇女的健康。
  
  他们发现,22-27岁的女性抽菸盛行率最高,达28%,73-78岁最低,为5%,不过,从20-90岁,不运动和高血压的盛行率逐渐上升,不运动比率从48%上升到81%,高血压比率从不到5%增加到47%。
  
  最年轻组(22-27岁)女性的过重增加最少,为46%;中年组(59-64岁)增加最多,达79.2%;之后再度降低到85-90岁组的62.4%。
  
  研究者另外也根据「Global Burden of Disease」这项研究估计相对风险,并应用到澳洲女性,相对风险资料指出有特定风险因素的女性相对于没有该风险因素之女性发生心脏病的可能性。
  
  合并盛行率和相对风险资料后,研究者发现,到30岁以上,抽菸是心脏病的最重要因子,人群归因风险值为59%,而73-78岁女性中,抽菸对心脏病的归因风险降到5.3%。
  
  相对的,22-27岁女性中,运动程度低或不运动的心脏病归因风险为47.2%,而31-36岁组增加到50.9%,之后逐渐降低到85-90岁的23.5%。另外,风险归因于身体质量指数最高的是31-36岁组的32.7%,归因于高血压最高的是56 -64岁组的10.7%。
  
  研究者估计,如果每个30-90岁的澳洲女性都可以达到每周建议运动量、相当于150分钟的中等强度运动,每年可挽救超过2,000名中年以上女性的生命。
  
  作者们也结论指出,随著年龄改变,心脏病之发生可归因于不同的风险因素。
  
  他们表示,必须持续努力令年轻人戒菸,但也需要更加强调目前不像过重和肥胖那么受注意的运动计画。
  
  资料来源:http://www.24drs.com/professional/list/content.asp?x_idno=7078&x_classno=0&x_chkdelpoint=Y
  

Inactivity May Cause More Heart Disease Than Smoking

By Laird Harrison
Medscape Medical News

Physical inactivity ranks higher than smoking, obesity, or high blood pressure among the causes of heart disease in Australian women older than 30 years, a new study shows.

"Programmes for the promotion and maintenance of physical activity deserve to be a much higher public health priority for women than they are now, across the adult lifespan," write Wendy J. Brown, PhD, from the Centre for Research on Exercise, Physical Activity and Health, School of Human Movement Studies, University of Queensland, St. Lucia, Australia, and colleagues.

The study was published online May 8 in the British Journal of Sports Medicine.

A previous study of the top 10 risk factors for disease worldwide put high blood pressure at the top, followed by smoking and air pollution from solid fuels.

However, Dr. Brown and colleagues hypothesize that circumstances are different in Australia than in other parts of the world. For example, Australians do not burn much solid fuel. The authors also thought risk factors might change with a woman's age.

Therefore, they set out to quantify the changing contribution made to a woman's likelihood of developing heart disease across her lifetime for each of the known top 4 risk factors in Australia: excess weight, smoking, high blood pressure, and physical inactivity.

They calculated the population-attributable risk, a mathematical formula used to define the proportion of disease in a defined population that would disappear if exposure to a specific risk factor were to be eliminated.

They based their calculations on estimates of the prevalence of the 4 risk factors among 32,154 participants in the Australian Longitudinal Study on Women's Health, which has been tracking the long-term health of women born in 1921-1926, 1946-1951, and 1973-1978 since 1996.

They found that the prevalence of smoking was highest among women aged 22 to 27 years, at 28%, and lowest in those aged 73 to 78 years, at 5%. However, the prevalence of inactivity and high blood pressure increased steadily across the lifespan from age 22 to 90 years, rising from 48% to 81% for inactivity and from less than 5% to 47% for hypertension.

Overweight increase was lowest, at 46%, in the youngest women (aged 22 - 27 years); peaked in middle age, at 79.2% in women aged 59 to 64 years; and then declined again in older age to 62.4% in women aged 85 to 90 years.

The researchers also used estimates of relative risk from the Global Burden of Disease study and applied them to the Australian women. Relative risk data indicate the likelihood that a woman with a particular risk factor will develop heart disease compared with someone without that risk factor.

Combining the prevalence and relative risk data, the researchers found that up to the age of 30 years, smoking was the most important contributor to heart disease, with a population-attributable risk of 59%, but its contribution to heart disease declined to 5.3% in women aged 73 to 78 years.

In contrast, "low" and "no" physical activity accounted for 47.2% of heart disease in women aged 22 to 27 years, rising to 50.9% in women aged 31 to 36 years and then gradually declining to 23.5% in women aged 85 to 90 years.

In contrast, the largest proportion of risk attributable to high body mass is 32.7% in women aged 31 to 36 years, and to hypertension is 10.7% in women aged 56 to 64 years.

The researchers estimate that if every Australian woman between the ages of 30 and 90 years were able to reach the recommended weekly exercise quota of 150 minutes of at least moderate intensity physical activity, then the lives of more than 2000 middle-aged and older women could be saved each year.

The authors also conclude that the contribution of different risk factors to the likelihood of developing heart disease changes across the lifespan.

Continuing efforts to curb smoking among the young are warranted, they say, but much more emphasis should be placed on physical inactivity, which, they say, has been dwarfed by the current focus on overweight and obesity.

The authors have disclosed no relevant financial interests.

Br J Sports Med. Published online May 8, 2014.

    
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