Physical activity and cardiovascular disease: evidence for a dose response
Physical activity and cardiovascular disease: evidence for a dose response
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DOI：
10.1097/00005768-200106001-00017
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发表时间：
2001-06-01
期刊：
影响因子：
--
通讯作者：
Kohl, HW
中科院分区：
文献类型：
--
作者：
Kohl, HW
目的：总结和综合现有文献，提供体力活动和心血管疾病终点之间剂量-反应关系的证据。方法：MEDLINE检索截至2000年8月的英文文献索引。现有共识文件和其他已发表文献补充的结果。仅纳入了两种以上体力活动暴露类别的研究，排除了不关注结局（发生率或死亡率）临床表现的研究。结果：现有研究按使用的结局分类：所有心血管疾病（CVD）、冠状动脉（缺血性）心脏病（CHD）和卒中。该领域的绝大多数文献依赖于前瞻性观察性研究，并且在欧洲男性或主要欧洲血统男性人群中进行。随访间隔从3年到26年不等，大多数研究将单一的身体活动初始测量与感兴趣的结果联系起来，有时是在未来的许多年。目前还没有关于体力活动和心血管疾病作为临床结局的随机试验。总之，现有的证据表明，心血管疾病的发病率和死亡率，特别是缺血性心脏病，是因果关系，以反向，剂量反应的方式与体力活动。这些发现已在各种人群中得到证实，并使用各种身体活动评估方法。因此，中风发病率和死亡率的证据不明确，不能得出类似的结论。没有强有力的证据表明体力活动与作为CVD结局的卒中之间存在剂量-反应关系。结论：缺乏身体活动是心血管疾病，特别是缺血性心脏病的易感因素的因果关系中的突出因素。体力活动评估的方法学进展;对前因变量体力活动变化的额外研究，因为它与结果有关;需要在女性和不同种族人群中进行更多研究以澄清这些关系。
Purpose: To summarize and synthesize existing literature providing evidence of a dose-response relation between physical activity and cardiovascular disease endpoints. Methods: MEDLINE search of indexed English-language literature through August 2000. Findings supplemented by existing consensus documents and other published literature. Only studies with greater than two physical activity exposure categories were included, and studies not focusing on the clinical manifestation of the outcome (incidence or mortality) were excluded. Results: Existing studies were classified by outcome used: all cardiovascular disease (CVD), coronary (ischemic) heart disease (CHD), and stroke. The vast majority of the literature in this area has relied on prospective observational studies and has been conducted in European men or populations of men of primarily European descent. Follow-up intervals ranged from 3 to 26 yr, and most studies related a single initial measure of physical activity to the outcome of interest, sometimes many years in the future. No randomized trials of physical activity and cardiovascular disease as a clinical outcome exist. Taken together, the available evidence indicates that cardiovascular disease incidence and mortality, and specifically ischemic heart disease, are causally related to physical activity in an inverse, dose-response fashion. These findings have been demonstrated in a variety of populations and using a variety of physical activity assessment methods. Contrarily, equivocal evidence for stroke incidence and mortality prohibits a similar conclusion. No strong evidence for dose-response relation between physical activity and stroke as a CVD outcome is available. Conclusion: Physical inactivity is prominent in the causal constellation for factors predisposing to cardiovascular disease, particularly ischemic heart disease. Methodologic advances in physical activity assessment; additional studies on changes in the antecedent variable, physical activity, as it relates to the outcome; and more studies among women and ethnically diverse populations are needed to clarify these relations.