中国中老年人群生活方式与心血管病发生风险关联:基于东风同济队列的综述

Association between lifestyle and incident risk of cardiovascular diseases in Chinese middle-aged and older adults:a review based on Dongfeng-Tongji Cohort

我国人口老龄化进程加快所带来的心血管疾病(cardiovascular disease,CVD)等慢性病问题日趋严峻,如何降低其发生已成为首要的公共卫生任务。关注中老年人群健康的东风同济队列于2008―2010年完成基线调查共纳入27009名研究对象,至2018年12月随访已逾10年,目前已经系统地探讨了多种生活方式与CVD的关联,发现单个或多个健康的生活方式均可降低CVD的风险。例如单次适量饮酒者与从不饮酒相比,可降低24%的冠心病(coronary heart disease,CHD)风险;经常饮绿茶与不饮绿茶相比,CHD风险降低11%;运动量达到WHO推荐值的3~5倍可降低约18%的CVD风险。坚持≥4项健康生活方式与≤1项相比,CVD风险降低39%。在5年间,从2项提高至≥4项,CVD和CHD的风险分别下降26%和20%。反之,不良生活方式可增加CVD的风险。如夜间睡眠时长过长者CHD和脑卒中风险分别增加33%和23%;而午休超过90 min,CHD和脑卒中的风险均增加25%。从≥4项健康生活方式减少至≤1项,发生CVD和CHD的风险升高76%和68%,而脑卒中风险增加达1.54倍。这些发现提示坚持多项健康生活方式可在一定程度上降低中老年人群CVD的发生风险,为公共卫生政策的制订提供了理论依据。

Chronic diseases including cardiovascular disease(CVD)are becoming more and more serious due to accelerated aging in China.How to reduce the occurrence of CVD has been the primary problem of public health.The association between multiple lifestyles and CVD has been systematically explored based on the Dongfeng-Tongji cohort,which focused on the health of middle-aged and older people.The baseline survey was completed in 2008-2010 and followed-up was executed over 10 years until December 2018.Results showed that single or multiple healthy lifestyles could decrease the risk of CVD.For example,moderate alcohol each time had a 24%reduced risk of coronary heart disease(CHD)than those who never drink.Regular consumption of green tea was associated with an 11%lower risk of CHD compared with no green tea consumption.The risk of CVD could be reduced by 18%when the amount of physical activity was up to 3-5 times of WHO recommended value.Adherence to≥4 healthy lifestyles had a 39%reduced risk of CVD.The risk of CVD and CHD subsequently decreased by 26%and 20%,respectively,with an improvement to≥4 healthy lifestyles from 2 during a 5-year period.In con-trast,poor lifestyles could increase the risk of CVD.Longer sleep duration was linked with a 33%and 23%increased CHD and stroke,respectively.Napping duration>90 minutes was associated with a 25%elevated risk of both CHD and stroke,respectively.The risk of CVD and CHD increased by 76%and 68%;the risk of stroke increased by 1.54 fold when≥4 healthy lifestyles were reduced to≤1.These findings suggest that adherence to multiple healthy lifestyles can reduce the risk of CVD in middle-aged and older adults to a certain extent,providing a theoretical footstone for the formulation of public health policies.