Eur Heart J:与健康人相比,心血管疾病患者从运动中获益更多

2019-09-17 佚名 中国生物技术网

一项涉及大约50万人的研究首次发现,与没有心血管疾病(CVD)的健康人相比,有心脏或血管问题的人从积极的体育生活方式中获益更多。在对CVD患者及非CVD患者进行为期6年的追踪研究中,研究人员发现,增加体育运动能降低死亡风险,但是,死亡风险降低最明显的是CVD患者,如果他们加大运动量,则风险还会进一步降低。这项近日发表在《European Heart Journal》上的研究同时也在法国巴黎举行的欧

一项涉及大约50万人的研究首次发现,与没有心血管疾病(CVD)的健康人相比,有心脏或血管问题的人从积极的体育生活方式中获益更多。



在对CVD患者及非CVD患者进行为期6年的追踪研究中,研究人员发现,增加体育运动能降低死亡风险,但是,死亡风险降低最明显的是CVD患者,如果他们加大运动量,则风险还会进一步降低。

这项近日发表在《European Heart Journal》上的研究同时也在法国巴黎举行的欧洲心脏病学会2019年度会议和世界心脏病学大会上发表。

有大量证据表明,体育运动可以降低健康人死于CVD的风险,虽然很多健康指南推荐体育运动,但其对CVD患者影响的证据却比较少,而且到目前为止,还没有研究比较有CVD和没有CVD的患者进行体育活动的有益影响。

由韩国国立首尔大学心脏学家Sang-Woo Jeong博士领导的研究团队分析了参与韩国国家健康保险服务健康筛查队列登记的总共441798人的数据,这些人在2009至2015年间接受了健康筛查项目,并完成了体育运动情况的调查。所有参与者年龄在40岁以上,平均年龄为60岁。CVD患者和未患CVD的人数分别为131558和310240,其中53.5%为男性。研究人员对他们进行了6年的跟踪随访研究,并从韩国国家死亡检索中收集了有关死亡和死因的信息。

关于体育运动的调查要求参与者们回忆在过去的七天的活动量,这个信息被转化为每周代谢当量(MET)分钟数(MET-分钟/周)。

研究共同作者、国立首尔大学心脏学家的Si-Hyuck Kang博士说:“2016年欧洲心脏学会(ESC)关于预防心血管疾病的健康指南推荐所有健康成年人每周至少进行150分钟中等强度运动或者75分钟高强度有氧运动,或者相当于这种运动量的组合。达到每周500MET-分钟的一种方法是,每周5次30分钟的健步走,另一种方法是每周进行一次剧烈的体育活动,比如持续75分钟的非负重爬山。如果要达到每周1500 MET-分钟,则可以将每周5次30分钟的健步走和2.5小时的爬山相结合。”

在随访期结束时,研究人员发现,与非CVD患者相比,CVD患者能够从体育运动中获益更多。对CVD患者和非CVD患者来说,增加500 MET-分钟/周,死亡风险分别降低14%和7%。

在调整了可能影响结果的因素,如年龄、性别、吸烟和其他疾病,对未患CVD的健康人士来说,0-499 MET-分钟/周的运动量最有益。完全不运动的人比运动量最大的人(1500 MET-分钟/周以上)死亡风险高出27%;而运动量在0-499 MET-分钟/周的人的这一数字则降低到8%。在此之后,运动量的增加与死亡风险降低之间的关联越来越小,在达到1000 MET-分钟/周后保持不变。

对CVD患者来说,尽管0-499 MET-分钟/周的运动量仍然效果最显著,但是在运动量增加到500 MET-分钟/周之后,死亡风险还会持续降低。与没有CVD且运动量最大的人相比,完全不运动和运动量为0-499 MET-分钟/周的CVD患者的死亡风险分别高出87%和45%。在每周进行1000分钟或更多运动量的CVD患者中,死亡风险进一步下降到14%。

Jeong博士说:“我们发现研究中大约有一半人没有达到推荐的业余时间运动量,四分之一的人完全不运动。心血管疾病患者的运动量低于非患病者,但是参与者的运动量越大,他们在后续6年的追踪研究期间的死亡风险就越低。这项研究的主要新发现在于,心血管疾病患者从体育运动中获得的益处比非心血管疾病患者更多。”

研究人员认为,他们的发现可以适用于其他国家的人,因为体育活动在心血管疾病中所起的作用是所有人群都共有的。

Kang博士说:“至于为什么CVD患者能够从运动中获益更多,有几种可能的解释。首先,久坐不动的生活方式是CVD的一个众所周知的风险因素。所以改变他们的生活方式、让他们多运动便能使他们受益。其次,过去的很多研究表明,体育活动有助于控制心血管风险因素,如血压、胆固醇和血糖等。体育活动在二级预防方面的益处在于它能更好地控制这些风险因素。最后,CVD患者通常比非CVD患者的系统性炎症水平更高,有证据表明,体育运动能够降低全身炎症水平。”

Kang博士说:“基于这些发现,医生们应该向心血管疾病患者强调运动生活方式的重要性,鼓励他们尽可能多的参加体育活动。运动多的人睡眠更好,心态更好,身体机能也更好。我们需要强调,体育运动是获得长寿、健康和快乐最经济的方法,而且几乎没有副作用。”

该研究存在的限制包括,参与者通过调查问卷的方式报告体育运动情况,而且没有包括正常生活中发生的体育运动,比如上班、通勤、做家务等。这份问卷调查主要关注于有氧运动,对肌肉和骨骼强化运动方面的信息有限。

原始出处:
Sang-Woo Jeong, Sun-Hwa Kim, Si-Hyuck Kang, et al. Mortality reduction with physical activity in patients with and without cardiovascular disease. European Heart Journal. Sep 2019.


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    2019-09-19 zhaojie88
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    2019-09-19 slcumt
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    2019-09-17 qingfengqishi5

    学习了,学习了

    0

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