不運動比抽菸更容易引起心臟病


  【24drs.com】一篇新研究顯示,對於30歲以上的澳洲女性,不運動比抽菸、肥胖、高血壓更容易引起心臟病。
  
  澳洲昆士蘭大學人類運動研究院運動體能活動暨健康研究中心Wendy J. Brown博士等人寫道,促進與維持女性體力的方案應比現在獲得更多公衛重視。
  
  這篇研究線上登載於5月8日英國運動醫學期刊。
  
  之前的一篇研究中,全球10大疾病風險因素是將高血壓列為首位,其次依序為抽菸和固體燃料引起的空氣汙染。
  
  不過,Brown博士等人假設,澳洲的情況和世界上其他地方是不相同的,例如,澳洲並未燃燒那麼多固體燃料,作者們也認為風險因素可能會隨女性的年紀而有所改變。
  
  因此,他們針對澳洲已知的前4大風險因素:過重、抽菸、高血壓、運動進行研究,以量化造成女性在各年齡階段發生心臟病的變化。
  
  他們計算人群歸因風險,這是一種用來定義特定人群之疾病比率的數學方式,如果曝露的某一特定風險因素消除時,則該風險會消失。
  
  他們是對「Australian Longitudinal Study on Women's Health」研究的32,154名參與者的4個風險因素之盛行率估計進行計算,該研究自1996年開始,長期追蹤在1921-1926、1946-1951、1973-1978等年份出生之婦女的健康。
  
  他們發現,22-27歲的女性抽菸盛行率最高,達28%,73-78歲最低,為5%,不過,從20-90歲,不運動和高血壓的盛行率逐漸上升,不運動比率從48%上升到81%,高血壓比率從不到5%增加到47%。
  
  最年輕組(22-27歲)女性的過重增加最少,為46%;中年組(59-64歲)增加最多,達79.2%;之後再度降低到85-90歲組的62.4%。
  
  研究者另外也根據「Global Burden of Disease」這項研究估計相對風險,並應用到澳洲女性,相對風險資料指出有特定風險因素的女性相對於沒有該風險因素之女性發生心臟病的可能性。
  
  合併盛行率和相對風險資料後,研究者發現,到30歲以上,抽菸是心臟病的最重要因子,人群歸因風險值為59%,而73-78歲女性中,抽菸對心臟病的歸因風險降到5.3%。
  
  相對的,22-27歲女性中,運動程度低或不運動的心臟病歸因風險為47.2%,而31-36歲組增加到50.9%,之後逐漸降低到85-90歲的23.5%。另外,風險歸因於身體質量指數最高的是31-36歲組的32.7%,歸因於高血壓最高的是56 -64歲組的10.7%。
  
  研究者估計,如果每個30-90歲的澳洲女性都可以達到每週建議運動量、相當於150分鐘的中等強度運動,每年可挽救超過2,000名中年以上女性的生命。
  
  作者們也結論指出,隨著年齡改變,心臟病之發生可歸因於不同的風險因素。
  
  他們表示,必須持續努力令年輕人戒菸,但也需要更加強調目前不像過重和肥胖那麼受注意的運動計畫。
  
  資料來源:http://www.24drs.com/professional/list/content.asp?x_idno=7078&x_classno=0&x_chkdelpoint=Y
  

Inactivity May Cause More Heart Disease Than Smoking

By Laird Harrison
Medscape Medical News

Physical inactivity ranks higher than smoking, obesity, or high blood pressure among the causes of heart disease in Australian women older than 30 years, a new study shows.

"Programmes for the promotion and maintenance of physical activity deserve to be a much higher public health priority for women than they are now, across the adult lifespan," write Wendy J. Brown, PhD, from the Centre for Research on Exercise, Physical Activity and Health, School of Human Movement Studies, University of Queensland, St. Lucia, Australia, and colleagues.

The study was published online May 8 in the British Journal of Sports Medicine.

A previous study of the top 10 risk factors for disease worldwide put high blood pressure at the top, followed by smoking and air pollution from solid fuels.

However, Dr. Brown and colleagues hypothesize that circumstances are different in Australia than in other parts of the world. For example, Australians do not burn much solid fuel. The authors also thought risk factors might change with a woman's age.

Therefore, they set out to quantify the changing contribution made to a woman's likelihood of developing heart disease across her lifetime for each of the known top 4 risk factors in Australia: excess weight, smoking, high blood pressure, and physical inactivity.

They calculated the population-attributable risk, a mathematical formula used to define the proportion of disease in a defined population that would disappear if exposure to a specific risk factor were to be eliminated.

They based their calculations on estimates of the prevalence of the 4 risk factors among 32,154 participants in the Australian Longitudinal Study on Women's Health, which has been tracking the long-term health of women born in 1921-1926, 1946-1951, and 1973-1978 since 1996.

They found that the prevalence of smoking was highest among women aged 22 to 27 years, at 28%, and lowest in those aged 73 to 78 years, at 5%. However, the prevalence of inactivity and high blood pressure increased steadily across the lifespan from age 22 to 90 years, rising from 48% to 81% for inactivity and from less than 5% to 47% for hypertension.

Overweight increase was lowest, at 46%, in the youngest women (aged 22 - 27 years); peaked in middle age, at 79.2% in women aged 59 to 64 years; and then declined again in older age to 62.4% in women aged 85 to 90 years.

The researchers also used estimates of relative risk from the Global Burden of Disease study and applied them to the Australian women. Relative risk data indicate the likelihood that a woman with a particular risk factor will develop heart disease compared with someone without that risk factor.

Combining the prevalence and relative risk data, the researchers found that up to the age of 30 years, smoking was the most important contributor to heart disease, with a population-attributable risk of 59%, but its contribution to heart disease declined to 5.3% in women aged 73 to 78 years.

In contrast, "low" and "no" physical activity accounted for 47.2% of heart disease in women aged 22 to 27 years, rising to 50.9% in women aged 31 to 36 years and then gradually declining to 23.5% in women aged 85 to 90 years.

In contrast, the largest proportion of risk attributable to high body mass is 32.7% in women aged 31 to 36 years, and to hypertension is 10.7% in women aged 56 to 64 years.

The researchers estimate that if every Australian woman between the ages of 30 and 90 years were able to reach the recommended weekly exercise quota of 150 minutes of at least moderate intensity physical activity, then the lives of more than 2000 middle-aged and older women could be saved each year.

The authors also conclude that the contribution of different risk factors to the likelihood of developing heart disease changes across the lifespan.

Continuing efforts to curb smoking among the young are warranted, they say, but much more emphasis should be placed on physical inactivity, which, they say, has been dwarfed by the current focus on overweight and obesity.

The authors have disclosed no relevant financial interests.

Br J Sports Med. Published online May 8, 2014.

    
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