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军队疗养员运动状况与心血管疾病危险因素的调查

首席医学网      2012年05月07日 14:06:03 Monday  
 
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作者:肖 瑄,许望纯,何丽英,宋 敏,杨 琳,陈丽华    作者单位:广州军区广州疗养院二科,广东 广州 510515

【摘要】  目的:了解运动与心血管危险因素之间的联系。方法:选择在广州疗养院疗养的750名军队在职或离退休干部作为调查对象,区分为运动组(488名)和非运动组(262名)。测量其血压、人体质量指数(BMI)、空腹血糖(FBS)、总胆固醇(TC)、甘油三酯(TG)、尿酸等心血管危险因素,通过问卷调查其运动方式、运动频率、每次运动时间及一日累计运动时间。结果:1.非运动组的收缩压、舒张压、BMI、FBS、TC、TG水平均显著高于运动组(P均<0.05),两组间年龄、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇、尿酸水平差异无显著性(P均>0.05);2.(1)两组每次运动时间(≥30 min、<30 min)、运动方式(步行、太极拳)的心血管危险因素异常率(简称危险率)无显著差异;(2)一日活动时间大于60min的危险率明显低于活动时间≤60min的(29.41% 比45.59%, P<0.05);自感运动强度在11~15之间的危险率明显低于运动强度小于11级的 (33.67% 比44.64%, P<0.05);(3)运动频率≥3次/周的危险率显著低于运动频率<3次/周的(31.47% 比48.43%)、运动坚持时间10~19年的心血管危险率显著低于运动坚持时间<10年的(28.83% 比39.89%), P均<0.05。结论:1.运动组的心血管危险程度较低,心血管危险因素有叠加作用; 2. 中老年患者每日运动60 min,自感运动强度11~15,运动频率≥3次/周,长期坚持有助于降低心血管病危险性。

【关键词】  运动;心血管疾病;危险因素

 Abstract:Objective:To study relationship between exercise and risk factors for cardiovascular diseases.Methods:A total of 750 military cadres retired or on the job, who received convalescence therapy in Guangzhou sanatorium, were enrolled as survey subjects, and divided into exercise group(488 cases), and no- exercise group (262 cases). The cardiovascular risk factors such as blood pressure, body mass index (BMI), fasting blood glucose(FBS), total cholesterol (TC), triglyceride (TG)and uric acid were measured. Questionnaires were used to survey mode of exercise, exercise frequency, exercise duration each time and total exercise time in a day. Results:1. In no-exercise group, levels of systolic blood pressure, diastolic blood pressure, BMI, FBS, TC and TG were significantly higher than those of exercise group (P<0.05 all), but there were no significant difference in age and levels of HDL-C, LDL-C and uric acid between the two groups(P>0.05 all); 2. (1) Abnormal rate of risk factors for cardiovascular diseases (call for short was risk rate, similarly hereinafter)in different exercise duration each time (≥30 min、<30 min)and exercise mode(walking, taijiquan)were no significant(P>0.05 all);(2)Risk rate in subjects who took exercise>60min in a day was significantly lower than that of those with ≤60min (29.41% vs. 45.59%), in subjects whose exercise intensity with RPE(Borg rating of perceived exertion scale)11~15 was significantly lower than that of with RPE<11 (33.67% vs. 44.64%), P<0.05 all;(3)Risk rate in subjects whose exercise frequency ≥3 times/week was significantly lower than that of with<3 times/week (31.47% vs.8.43%), in subjects whose persistence time of exercise was 10~19 years was significantly lower than that of with<10 years, P<0.05 all.Conclusion:1. Risk extent of cardiovascular diseases is lower in exercise group, and there is additive effect in risk factor for cardiovascular diseases; 2. take exercise>60min/d, Borg rating of perceived exertion scale 11~15, exercise frequency ≥3 times/week and long time persistence are conduce to decrease risk of cardiovascular diseases in middle-aged and aged persons.

  Key words: Exercise; Cardiovascular diseases;Risk factors

  Hypertension, obesity, pathoglycemia and dyslipidemia are independent risk factors for cardiovascular diseases, multiple risk factors possess additive effect on risk of cardiovascular diseases [1]. There are evidences proving that regular physical exercise can reduce risk of occurrence of coronary heart disease, stroke, type 2 diabetes mellitus and hypertension [2],but relationship among amount, duration, intensity of exercise and these risk factors need further study. Therefore, a study for relationship among exercise condition and risk factors of cardiovascular diseases was performed among retired military cadres or military cadres on the job who received convalescence therapy in Guangzhou sanatorium, intend to provide evidence for effective exercise interfering risk factors of cardiovascular diseases.

  1 Subjects and Methods

  1.1 Subjects

  A total of 750 military cadres retired or on the job, who received convalescence therapy in Guangzhou sanatorium of Guangzhou military command from Jan 2010 to Dec 2010, were enrolled as survey subjects. There were 418 men and 332 women with age 45~86 (66±4) years old.

  1.2 Questionnaire survey

  All inquiring officers underwent training and were qualified. Single-blind method was used to perform questionnaire survey. Content of the questionnaire included general conditions, medical history and exercise history. Exercise conditions included main exercise mode, exercise duration each time, exercise intensity and frequency, and persistence of exercise etc. Main exercise mode included walking, jogging or traditional items such as taijiquan, wuqinxi etc. According to exercise duration each time, subjects were divided into<30min group and ≥30min group; According to total exercise time in a day, they were divided into<60min group and ≥60min group. Borg rating of perceived exertion scale (RPE) was used to evaluate exercise intensity, 11 was regard as light, 13 as somewhat hard, 15 as hard (heavy), subjects were divided into<11 group and 11~15 group. According to exercise frequency, they were divided into

  Those had no exercise history or took exercise occasionally were regard as no-exercise group; those took exercise≥1~3 times/week and persistence for over five years were regard as exercise group.

  1.3 Measurements

  All subjects underwent physical examinations, including body weight (kg), height (m), blood pressure (mmHg). Blood samples were taken for measurements of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and uric acid (UA). Body mass index (BMI) = body weight (kg) /height (m)2. Risk factors for cardiovascular diseases included: 1、Blood pressure≥140/90mmHg or received antihypertensive drug therapy; 2、Obesity(BMI≥28kg/m2); 3、FBS≥7.0mmol/L or received hypoglycemic therapy; 4、dyslipidemia: (1)HDL-C<1.04mmol/L,(2)TC≥6.2mmol/L,(3)TG≥1.7 mmol/L,(4)LDL-C≥4.2 mmol/L;5、Uric acid ≥450mmol/L.Abnormal rate of risk factors for cardiovascular diseases =positive cases of risk factors for cardiovascular diseases/total cases.

  1.4 Statistical process

  SPSS 13.0 statistical software package was used to perform statistical process. Measurement data were presented as mean value ± standard deviation(x-±s). Comparison between two groups was used t test; Numeration data were presented as percentage. Chi-square test was used to analyze relationship among different exercise indicators and abnormal rate of risk factors for cardiovascular diseases(call for short was risk rate, similarly hereinafter), P<0.05 was regard as possessing significant difference.

  2 Results

  2.1 Comparisons of risk factors for cardiovascular diseases

  Levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, FBG, TC and TG in no-exercise group were significantly higher than those of exercise group (P<0.05 all). There were no significant difference in age and levels of HDL-C, LDL-C and UA between the two groups (P>0.05), were shown in table 1.Table 1 Comparisons of risk factors for cardiovascular diseases between two groups

  2.2 Comparisons of risk rate for different exercise conditions

  The results indicated that risk rate of different exercise duration each time and exercise mode was no significant difference; Risk rate of subjects who took exercise>60min in a day was significantly lower than that of those with ≤60min; Risk rate of subjects whose exercise intensity was 11~15 was significantly lower than that of those with<11; Risk rates in those who possessed high frequency and long persistence time of exercise were significantly lower than those of corresponding group, P<0.05 all, were shown in table 2.Table 2 Relationship among exercise indicators and risk rate for cardiovascular diseases

  3 Discussion

  Now, physical inactivity has become No.4 risk factor of death in world. Ratio of persons with physical inactivity continuously increase in many countries, which have important effect on general health condition and incidence rates of chronic non-infectious disease diseases in worldwide population[2].

  There are two main kinds of risk factors for cardiovascular diseases: genetic factor and environmental factor. The former mainly includes unchangeable factors such as age, gender, race and inheritance history. The latter includes obesity, hypertension, hyperglycemia and hyperlipidemia etc, which are changeable. The present study indicated that levels of SBP, DBP, BMI, FBG, TC and TG in no-exercise group were significantly higher than those of exercise group, indicating that risk extent of cardiovascular diseases was higher in no-exercise group. It proved that physical inactivity contributes to increase of risk factors for cardiovascular diseases, and they possessed additive effect on occurrence of cardiovascular diseases,in accordance with literature[3].

  The results of present study indicated that risk extent of cardiovascular diseases is lower in subjects whose total exercise time in a day>60min, with medium exercise intensity, high frequency of exercise and long persistence time of exercise.

  If middle-aged or aged patients cannot continuously complete 30~60min exercise duration, they can choose to accomplish total exercise time and amount with accumulation methods of small amount, short duration, many times, and it may decrease adverse reactions for exercise such as muscle impair and improves compliance of exercise.

  Therefore, medical staff in sanatorium should promote convalescents and other subject to take physical exercises as much as they can, and provide proper guide on exercise to improve their physical ability.

【参考文献】
    [1]谭家余,吴赛珠,黄汉卿,等. 男性血清生物有效性睾酮与心血管病危险因素个体聚集性的相关性现况调查[J]. 中华老年多器官疾病杂志,2003,2(3):192-194.

  [2]世界卫生组织. 关于身体活动有益健康的全球建议. 2010:1-54.

  [3]刘江生,马琛明,涂良珍,等.“中国心血管病人生活质量评定问卷”常模的测定[J].心血管康复医学杂志,2009,18(4):305-309.

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