Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study
Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study
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DOI：
10.5271/sjweh.2913
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发表时间：
2010-09-01
影响因子：
6.3
通讯作者：
Suadicani, Poul
中科院分区：
文献类型：
--
作者：
Holtermann, Andreas;Mortensen, Ole Steen;Suadicani, Poul
目的以前没有长期的前瞻性研究，检查是否有低心肺功能的工人有心血管死亡的风险增加，由于高体力工作的要求。我们测试了这个hypothes.Method我们进行了30年的随访哥本哈根男性研究的5249就业男性年龄在40-59岁。我们从随访中排除了274名有心肌梗死病史、心绞痛的普遍症状或间歇性跛行的男性。我们估计体能[最大耗氧量（VO（2）最大）]使用Astrand骑自行车测试和确定体力劳动的需求与两个自我报告的questions.Results在哥本哈根男性研究，587人（11.9%）死于缺血性心脏病（IHD）。以体力劳动要求低的男性为参照组，经年龄、血压、吸烟、饮酒、体重指数、糖尿病和高血压调整后的考克斯分析显示，体力劳动要求高与最不适合的IHD死亡风险增加相关[VO（2）最大范围15-26，N=892，风险比（HR）2.04，95%置信区间（95% CI）1.20-3.49]和中等健康（VO（2）最大范围27-38，N=3037，HR 1.75，95% CI 1.24-2.46），但不是最健康的男性（VO（2）最大范围39-78，N=1014，HR 1.08，95% CI 0.52-2.17）。我们发现了一个类似的，虽然稍弱，关系方面的全因mortality.Conclusions的假设得到了支持。低和中等身体素质的男性如果暴露于高体力工作要求，则心血管和全因死亡的风险增加。我们的观察表明，在体力工作要求高的男性中，身体健康可以防止心血管不良反应。
Objective No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis.Method We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 employed men aged 40-59 years. We excluded from follow-up 274 men with a history of myocardial infarction, prevalent symptoms of angina pectoris, or intermittent claudication. We estimated physical fitness [maximal oxygen consumption (VO(2)Max)] using the Astrand cycling test and determined physical work demands with two self-reported questions.Results In the Copenhagen Male Study, 587 men (11.9%) died due to ischaemic heart disease (IHD). Using men with low physical work demands as the reference group, Cox analyses-adjusted for age, blood pressure, smoking, alcohol consumption, body mass index, diabetes, and hypertension-showed that high physical work demands were associated with an increased risk of IHD mortality in the least fit [VO(2)Max range 15-26, N=892, hazard ratio (HR) 2.04, 95% confidence interval (95% CI) 1.20-3.49] and moderately fit (VO(2)Max range 27-38, N=3037, HR 1.75, 95% CI 1.24-2.46), but not among the most fit men (VO(2)Max range 39-78, N=1014, HR 1.08,95% CI 0.52-2.17). We found a similar, although slightly weaker, relationship with respect to all-cause mortality.Conclusions The hypothesis was supported. Men with low and medium physical fitness have an increased risk of cardiovascular and all-cause mortality if exposed to high physical work demands. Ours observations suggest that, among men with high physical work demands, being physically fit protects against adverse cardiovascular effects.