缺乏体力活动是女性心脏病的最重要危险因素

《英国运动医学杂志》（British Journal of Sports Medicine）发表的一项澳大利亚研究显示，在30岁以前，吸烟是澳大利亚女性发生心脏病的最重要危险因素，但从30岁起至80岁，缺乏体力活动是最重要的危险因素(Br. J. Sports Med. 2014 May 8 [doi:10.1136/bjsports-2013-093090])。

在这项研究中，澳大利亚昆士兰大学锻炼、体力活动和健康研究中心的Wendy Brown教授及其同事分析了澳大利亚成人女性的缺血性心脏病的人群归因危险度。所分析的4种危险因素为：过重[高体重指数（BMI）]、吸烟、高血压和缺乏体力活动。

研究者的估算值基于澳大利亚女性健康纵向研究中这4种危险因素的现患率，该研究对1921~1926年、1946~1951年、 1972~1978年和自1996年出生的32,154例女性的长期健康进行了跟踪。

研究者发现，吸烟现患率在22~27岁女性中为28%，在73~78岁女性中降至5%。然而，缺乏体力活动和高血压现患率在22~90岁女性中随年龄增加，体重增长在22~64岁女性中随年龄增加但在64岁以上女性中出现降低。

研究者使用人群归因危险度（PAR）的数学公式来定义在消除特异性危险因素暴露情况下将消失的疾病比例是多少。

研究者发现，所有4种危险因素的相对危险度随年龄降低，但缺乏体力活动、高BMI和高血压现患率随年龄增加，而吸烟现患率随年龄降低。

总体而言，中年组和老年组缺乏体力活动的平均PAR分别为33%和24%。具体而言，缺乏体力活动的PAR随年龄明显增加，在73~78岁女性中为65%，在85~90岁女性中为81%。

该研究发现每年有1,261例中年女性和9,151例老年女性死于心脏病。中年组和老年组体力活动增加可使每年的死亡例数减少2,612例。

研究者建议继续在年轻女性开展戒烟项目和在所有年龄的女性中推广体力活动。此外，研究者还建议目前缺乏体力活动的30~90岁女性每周至少进行150 min的中度活动。

该研究获澳大利亚政府卫生和老龄部资助。研究者声明无经济利益冲突。

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By: REBECCA KERN, Cardiology News Digital Network

FROM THE BRITISH JOURNAL OF SPORTS MEDICINE

VITALS

Major finding: Of four cardiovascular risk factors – high BMI, physical inactivity, smoking, and high blood pressure, physical inactivity had the greatest impact on developing heart disease after age 30.

Data source: Australian Longitudinal Study on Women’s Health, which has tracked the long-term health of 32,154 women born in 1921-1926, 1946-1951, and 1972-1978, since 1996.

Disclosures: The study was sponsored by the Australian Government Department of Health and Ageing. The investigators had no competing interests.

Physical inactivity in women aged 30 years and older has a greater impact on the risk of developing heart disease than any other major risk factor, according to an Australian study published today in the British Journal of Sports Medicine.

Wendy Brown, Ph.D., professor in the Centre for Research on Exercise, Physical Activity, and Health at the University of Queensland, Australia, and her fellow researchers, found that up to age 30 years, smoking was the most important contributor to heart disease in Australian women, but from age 30-80 years, physical inactivity was the top risk factor.

The researchers looked at the population attributable risk of ischemic heart disease in adult Australian women. They looked at four risk factors: excess weight (high body mass index); smoking; high blood pressure, and physical inactivity.

They based their estimates on the four risk factors’ prevalence in the Australian Longitudinal Study on Women’s Health, which has tracked the long-term health of 32,154 women born in 1921-1926, 1946-1951, and 1972-1978, since 1996.

The researchers found that smoking prevalence fell from 28% in women aged 22-27 years to 5% in those aged 73-78 years. However, the prevalence of inactivity and high blood pressure increased from age 22-90 years, and weight gain increased from age 22-64 years, but dropped in older age (Br. J. Sports Med. 2014 May 8 [doi:10.1136/bjsports-2013-093090]).

The researchers used a mathematical formula known as population attributable risk (PAR) to define the proportion of disease that would disappear if exposure to a specific risk factor were eliminated.

They found that relative risks for all four risk factors declined with age, but prevalence of physical inactivity, high BMI, and high blood pressure increased with age, while smoking prevalence decreased.

Overall, the average PAR for physical inactivity was 33% in the middle-age group and 24% in the older-age group. Specifically, the PAR for physical inactivity increased dramatically over time from 65% in women aged 73-78 years to 81% in women aged 85-90 years.

The study found that 1,261 middle-age and 9,151 older women die from heart disease every year. With increased physical activity in both age groups, the number of deaths could be reduced by 2,612 per year.

The researchers recommend to continue smoking cessation programs among younger women, and to promote physical activity in women of all ages. They also recommend at least 150 minutes of moderate activity per week for women aged 30-90 years who are currently inactive.

Dr. Carl "Chip" Lavie, medical director of cardiac rehabilitation and the exercise laboratories at the Ochsner Heart and Vascular Institute, New Orleans, says he is impressed with the study and supports its recommendations for increased physical activity.

"This is a very important study that emphasizes the fact that physical inactivity is probably the leading threat to health in the U.S. and most of the Western world, and it is clearly the case in Australia," he said.

The study was sponsored by the Australian Government Department of Health and Ageing. The investigators had no competing interests.