环境获得运动机会在心血管疾病死亡率中的作用：来自一项全国性研究的证据。

IF 7 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

BMC Medicine Pub Date : 2025-04-18 DOI:10.1186/s12916-025-04060-8

Xiaowen Wang, Yongshi Gu, Ying Wang, Yuqing Qiu, Tianling Chen, Philip K Hopke, Kai Zhang, Shao Lin, Yanji Qu, Ziqiang Lin, Xinlei Deng, Jie Sun, Shuming Zhu, Xueqing Deng, Sizhe Li, Xian Lin, Zhicheng Du, Yuantao Hao, Wangjian Zhang

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引用次数: 0

摘要

背景：获得锻炼机会的环境在决定人群的身体活动水平方面起着至关重要的作用。然而，目前尚不清楚环境因素如何导致体育活动和健康结果的差异。我们探讨了美国各县的县级运动机会与心血管疾病（CVD）死亡率之间的关系。方法：我们使用来自两个主要来源的汇总数据进行了生态分析：县健康排名和路线图数据以及CDC WONDER死亡率数据。我们比较了在获得锻炼机会和缺乏身体活动的四分位数中，县级年龄调整后的心血管疾病死亡率。根据年龄、性别、种族和城市化变量进行分层。心血管疾病死亡率的比率（RR）也用广义线性模型计算。结果：我们观察到CVD死亡率在不同水平的运动机会获得和不运动中存在显著差异，这在所有人口亚组中是一致的(P结论：在城市化背景下，各国有可能通过增加运动机会来改善其人口的心血管健康，从而在环境方面取得重大进展。

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The role of environmental access to exercise opportunities in cardiovascular mortality: evidence from a nationwide study.

Background: Environmental access to exercise opportunities plays a crucial role in determining the level of physical activity within a population. However, it is unclear how environmental factors contribute to disparities in physical activity and health outcomes. We explored the associations between county-level access to exercise opportunities and cardiovascular disease (CVD) mortality across US counties.

Methods: We conducted an ecological analysis using aggregated data from two primary sources: the County Health Rankings and Roadmaps data and CDC WONDER mortality data. We compared county-level age-adjusted CVD mortality across county-level quartiles of access to exercise opportunities and physical inactivity. Stratification was performed based on age, sex, race, and urbanization variables. The rate ratio (RR) for CVD mortality was also calculated using generalized linear models.

Results: We observed significant variations in CVD mortality across different levels of exercise opportunities access and physical inactivity, which was consistent across all demographic subgroups (P < 0.001). Access to exercise opportunities was significantly associated with a reduced risk of CVD mortality (RR = 0.93 [0.91-0.95]), and the association was most pronounced for acute myocardial infarction (AMI) mortality (RR, 0.80 [0.76-0.85]). The county-level physical inactivity was significantly associated with an increased risk of CVD mortality (RR, 1.16 [1.14-1.17]), especially for ischemic heart disease (IHD) (RR, 1.35 [1.31-1.38]) and AMI (RR, 1.32 [1.25-1.38]). All demographic subgroups demonstrated similar benefits in reducing the risk of CVD by improving the county-level indicators of physical activity.

Conclusions: Counties have the potential to make significant environmental strides in improving the cardiovascular health of their populations by enhancing access to exercise opportunities in the context of urbanization.

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.