背景:身体活动对维持和促进健康很重要。这在患有先天性心脏病(CHD)的患者中特别感兴趣,其中应预防获得性心脏病。世界卫生组织(WHO)建议至少每周2.5小时的身体活动超过3代谢当量(METS),以实现积极的健康效果。尚不清楚成年CHD患者的身体活动水平(PAL)是否因原籍国而异。
方法:从5大洲15个国家招募的3896名冠心病成年人完成了自我报告的仪器,包括健康行为量表(HBS-CHD),在APPROACH-IS项目中。对于每个病人来说,我们计算了世卫组织的建议是否实现.使用广义线性混合模型研究了相关因素。
结果:平均而言,31%的人达到了世卫组织的建议,但地理区域之间差异很大(印度:10%-挪威:53%)。身体活动水平的预测指标符合世卫组织的建议,以居住国为随机效应,男性(OR1.78,95CI1.52-2.08),NYHA-I级(OR3.10,95CI1.71-5.62)和较不复杂的疾病(OR1.46,95CI1.16-1.83)。相比之下,年龄较大(OR0.97,95CI0.96-0.98),较低的教育水平(OR0.41,95CI0.26-0.64)和失业(OR0.57,95CI0.42-0.77)与达到WHO建议呈负相关.
结论:相当比例的CHD患者未达到WHO建议的体力活动。不同原籍国的身体活动水平差异很大。根据确定的预测因素,可以识别易受伤害的患者并提供特定的行为干预措施。
BACKGROUND: Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease (CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents (METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin.
METHODS: 3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated whether WHO recommendations were achieved or not. Associated factors were investigated using Generalized Linear Mixed Models.
RESULTS: On average, 31% reached the WHO recommendations but with a great variation between geographical areas (India: 10%-Norway: 53%). Predictors for physical activity level in line with the WHO recommendations, with country of residence as random effect, were male sex (OR 1.78, 95%CI 1.52-2.08), NYHA-class I (OR 3.10, 95%CI 1.71-5.62) and less complex disease (OR 1.46, 95%CI 1.16-1.83). In contrast, older age (OR 0.97, 95%CI 0.96-0.98), lower educational level (OR 0.41, 95%CI 0.26-0.64) and being unemployed (OR 0.57, 95%CI 0.42-0.77) were negatively associated with reaching WHO recommendations.
CONCLUSIONS: A significant proportion of patients with CHD did not reach the WHO physical activity recommendations. There was a large variation in physical activity level by country of origin. Based on identified predictors, vulnerable patients may be identified and offered specific behavioral interventions.