THE ASSOCIATION OF CHANGES IN PHYSICAL-ACTIVITY LEVEL AND OTHER LIFE-STYLE CHARACTERISTICS WITH MORTALITY AMONG MEN
THE ASSOCIATION OF CHANGES IN PHYSICAL-ACTIVITY LEVEL AND OTHER LIFE-STYLE CHARACTERISTICS WITH MORTALITY AMONG MEN
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DOI：
10.1056/nejm199302253280804
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发表时间：
1993-02-25
影响因子：
158.5
通讯作者：
KAMPERT, JB
中科院分区：
文献类型：
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作者：
PAFFENBARGER, RS;HYDE, RT;KAMPERT, JB
背景最近增加体育锻炼、戒烟和避免肥胖的趋势可能会延长寿命。我们分析了哈佛学院校友生活方式的变化以及这些变化与死亡率的关系。1977年时年龄在45岁至84岁之间，在1962年或1966年以及1977年完成的问卷调查中没有报告有危及生命的疾病的男性，根据第一次和第二次问卷调查之间生活方式特征的变化进行分类。我们分析了1977年至1985年期间他们的体力活动水平、吸烟、血压和体重的变化，以及这些因素与死亡率的关系。在10，269名男性中，有476人在此期间死亡（总计90，650人-年的观察）。开始中等强度的体育活动（强度为4.5或更高的代谢当量）与不进行中等强度体育活动相比，死亡风险降低23%（95%置信区间为4%至42%; P = 0.015）。戒烟比继续吸烟的风险低41%（95%置信区间，20%至57%; P = 0.001），但比持续不吸烟的风险高23%。近期诊断为高血压的男性死亡风险低于长期高血压患者（相对风险为0.75; 95%置信区间为0.55 ~ 1.02; P = 0.057），血压一直正常的男性也是如此（相对风险为0.52; 95%置信区间为0.40 ~ 0.68; P < 0.001）。与长期、近期或既往肥胖相比，维持瘦体重与较低的死亡率相关。生活方式的改变和死亡率之间的关联是独立的，并且基本上不受年龄的影响。我们对冠心病死亡的研究结果反映了所有原因死亡的结果。开始适度剧烈的体育活动，戒烟，保持正常的血压，避免肥胖分别与中年和老年男性中各种原因和冠心病的死亡率较低有关。
Background. Recent trends toward increasing physical exercise, stopping cigarette smoking, and avoiding obesity may increase longevity. We analyzed changes in the lifestyles of Harvard College alumni and the associations of these changes with mortality.Methods. Men who were 45 to 84 years of age in 1977 and who had reported no life-threatening disease on questionnaires completed in 1962 or 1966 and again in 1977 were classified according to changes in lifestyle characteristics between the first and second questionnaires. We analyzed changes in their level of physical activity, cigarette smoking, blood pressure, and body weight, and the relation of these factors to mortality between 1977 and 1985.Results. Of the 10,269 men, 476 died during this period (which totaled 90,650 man-years of observation). Beginning moderately vigorous sports activity (at an intensity of 4.5 or more metabolic equivalents) was associated with a 23 percent lower risk of death (95 percent confidence interval, 4 to 42 percent; P = 0.015) than not taking up moderately vigorous sports. Quitting cigarette smoking was associated with a 41 percent lower risk (95 percent confidence interval, 20 to 57 percent; P = 0.001) than continuing smoking, but with a 23 percent higher risk than constant nonsmoking. Men with recently diagnosed hypertension had a lower risk of death than those with long-term hypertension (relative risk, 0.75; 95 percent confidence interval, 0.55 to 1.02; P = 0.057), as did men with consistently normal blood pressure (relative risk, 0.52; 95 percent confidence interval, 0.40 to 0.68; P < 0.001). Maintenance of lean body mass was associated with a lower mortality rate than long-term, recent, or previous obesity. The associations between changes in lifestyle and mortality were independent and were largely undiminished by age. Our findings on death from coronary heart disease mirrored those on death from all causes.Conclusions. Beginning moderately vigorous sports activity, quitting cigarette smoking, maintaining normal blood pressure, and avoiding obesity were separately associated with lower rates of death from all causes and from coronary heart disease among middle-aged and older men.