تأثیر فعالیت جسمانی منظم به‌عنوان یک بخش اساسی اصلاح سبک زندگی بر کاهش عوامل خطر قلبی- عروقی

نویسندگان

  • Mohammad-Reza Naghii1 دانشگاه علوم پزشکی بقیه ا... (عج) تهران- دانشکده بهداشت- مرکز تحقیقات فیزیولوژی ورزشی- استاد.
  • Mahdi Almadadi دانشگاه علوم پزشکی بقیه ا... (عج) تهران- دانشکده بهداشت- پژوهشگر.

DOI::

https://doi.org/10.22100/jkh.v6i1.92

کلمات کلیدی:

فعاليت جسماني، بيماري‌هاي قلبي- عروقي، عوامل خطر، پرسنل نظامي.

چکیده

مقدمه: فعاليت جسماني از ديرهنگام محور اصلي اقدامات مداخله‌اي در كاهش بار تحميلي بیماری‌های قلبی- عروقی بوده است. هدف اين مطالعه‌ بررسي ارتباط بين فعاليت و عدم فعاليت با عوامل خطر بيماري‌هاي قلبي- عروقي در افراد نظامي سالم مي‌باشد.

مواد و روش‌ها: شاخص‌هاي تن‌سنجی، تابلوی ليپيد- ليپوپروتئين، فشارخون و قند خون ناشتا در دو گروه فعال (50=n) و غير فعال (50=n) مورد ارزيابي قرار گرفت.

نتايج: افراد داراي فعاليت جسماني به‌طور معناداري داراي اندازه‌هاي کم‌تر شاخص‌هاي بدني (به استثناي قد)، سطوح کم‌تر کلسترول تام، ليپوپروتئين با چگالي کم، تري‌گليسيريد، فشارخون سيستوليک و دياستوليک، عامل خطر (نسبت کلسترول تام/ ليپوپروتئين با چگالي بالا)، شاخص آتروژنيک (نسبت ليپوپروتئين با چگالي کم/ ليپوپروتئين با چگالي بالا) و سطوح بيش­تر ليپوپروتئين با چگالي بالا بودند. ضرايب همبستگي ساده نشان داد که شاخص توده‌ بدني و نسبت دور کمر به دور باسن، به­طور معنا‌داري با فشارخون سيستوليک در گروه غير فعال ارتباط مثبت و شاخص توده‌ بدني ارتباط معکوس با ليپوپروتئين با چگالي بالا در هر دو گروه داشت که در گروه غير فعال از ميزان بيش­تري برخوردار بوده و محيط دور کمر ارتباط معکوس با ليپوپروتئين با چگالي بالا در گروه غيرفعال داشت.

نتيجه‌گيري: با کاهش عوامل خطر بروز حوادث قلبي- عروقي و پيشگيري قابل توجه از پيشرفت آن، خواص مفيد فعاليت جسماني برجسته مي‌شود و به تأثير آن به­عنوان يک اقدام حمايتي براي برخوردار بودن از سبک زندگي سالم‌تر در جامعه و به­ويژه در ميان پرسنل نظامي مي‌توان تأکيد و اشاره كرد

مراجع

Thelle DS. The causal role of blood lipids in the etiology of coronary heart disease-an epidemiologist's perspective. Scand Cardiovasc J 2008;42(4):274-8.

Greenfeder S. Emerging strategies and agents to lower cardiovascular risk by increasing high density lipoprotein cholesterol levels. Current Medicinal Chemistry 2009;16(2):144-156.

Norata GD, Catapano AL. Molecular mechanisms responsible for the antiinflammatory and protective effect of HDL on the endothelium. Vasc Health Risk Manag 2005;1(2):119-129.

Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 2003;326:1423.

Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004;110:227-39.

Singh IM, Shishehbor MH, Ansell BJ. High-density lipoprotein as a therapeutic target: a systematic review. JAMA 2007;298(7):786-98.

Powers E, Saultz J, Hamilton A, Lo V. Clinical inquiries. Which lifestyle interventions effectively lower LDL cholesterol? J Fam Pract 2007;56(6):483-5.

Volaklis KA, Spassis AT, Tokmakidis SP. Land versus water exercise in patients with coronary artery disease: effects on body composition, blood lipids, and physical fitness. Am Heart J 2007;154:560-566.

Understanding Adult Obesity. Institutes of Health (NIH) Publication No. 04-4352. April NIH Publication No. 98-4083. 1998. National Task Force on Prevention and Treatment of Obesity. Available from: URL: win. niddk.nih.gov/publications/understanding.htm.

Painter P. Exercise in chronic disease: physiological research needed. Exerc Sport Sci Rev 2008;36(2):83-90.

Leon AS, Franklin BA, Costa F, Balady GJ, Berra KA, Stewart KJ, Thompson PD, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005;111:369-76.

Smith SC Jr, Allen J, Blair SN, Bonow RO, Brass LM, Fonarow GC, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation 2006;113(19):2363-72.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289(19):2560-72.

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults . Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.

Vasan RS, Sullivan LM, Wilson PW, Sempos CT, Sundström J, Kannel WB, Levy D, D'Agostino RB. Relative Importance of borderline and elevated levels of coronary heart disease risk factors. Ann Intern Med 2005;142(6):393-402.

Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006;367(9524):1747-57.

Murray CJ, Lauer JA, Hutubessy RC, Niessen L, Tomijima N, Rodgers A, Lawes CM, et al. Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: a global and regional analysis on reduction of cardiovascular-disease risk. Lancet 2003;361(9359):717-25.

World Health Organization. The Atlas of Heart Disease and Stroke. 2008 October Available from: URL:http://www.who.int/ cardiovascular_diseases/resources/atlas/en /index.html.

Sarrafzadegan N, Kelishadi R, Esmaillzadeh A, Mohammadifard N, Rabiei K, Roohafza H, Azadbakht L, et al. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran. Bull World Health Organ 2009;87:39-50.

Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, Ellis SG, et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA 2003;290:898-904.

Gregg EW, Cheng YJ, Cadwell BL, Imperatore G, Williams DE, Flegal KM, Narayan KM, et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA 2005;293: 1868-74.

Libby P. The forgotten majority: unfinished business in cardiovascular risk reduction. J Am Coll Cardiol 2005;46: 1225-8.

Gillies CL, Abrams KR, Lambert PC, Cooper NJ, Sutton AJ, Hsu RT, et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ 2007;334:299.

Dzau VJ, Antman EM, Black HR, Hayes DL, Manson JE, Plutzky J, et al. The cardiovascular disease continuum validated: clinical evidence of improved patient outcomes: part I: Pathophysiology and clinical trial evidence (risk factors through stable coronary artery disease). Circulation 2006;114:2850-70.

Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007;39:1423-34.

Mora S, Cook N, Buring JE, Ridker PM, Lee IM. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation 2007;116:2110-8.

Grundy SM. Obesity, metabolic syndrome, and coronary atherosclerosis. Circulation 2002;105:2696-8.

Carmena R, Duriez P, Fruchart JC. Atherogenic lipoprotein particles in atherosclerosis. Circulation 2004;109:1112-7.

Christou DD, Gentile CL, DeSouza CA, Seals DR, Gates PE. Fatness is a better predictor of cardiovascular disease risk factor profile than aerobic fitness in healthy men. Circulation 2005;111:1904-14.

Al-Qahtani DA, Imtiaz ML, Shareef MM. Obesity and cardiovascular risk factors in Saudi adult soldiers. Saudi Med J 2005;26:1260-8.

Al-Qahtani DA, Imtiaz ML. Prevalence of metabolic syndrome in Saudi adult soldiers. Saudi Med J 2005;26:1360-6.

Khazale NS, Haddad F. Prevalence and characteristics of metabolic syndrome in 111 Royal Jordanian Air Force pilots. Aviat Space Environ Med 2007;78:968-72.

Mikkola I, Keinänen-Kiukaanniemi S, Laakso M, Jokelainen J, Härkönen P, Meyer-Rochow VB, et al. Metabolic syndrome in connection with BMI in young Finnish male adults. Diabetes Res Clin Pract 2007;76:404-9.

Laclaustra-Gimeno M, González-García MP, Casasnovas-Lenguas JA, Luengo-Fernández E, León-Latre M, Portero-Pérez P, et al. Cardiovascular risk factor progression in young males at 15-year follow-up in the general military academy of zaragoza (agemza) study. Rev Esp Cardiol 2006;59:671-8.

Leon AS, Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001;33:S502-15.

Kraus WE, Houmard JA, Duscha BD, Knetzger KJ, Wharton MB, McCartney JS, et al. Effects of the amount and intensity of exercise on plasma lipoproteins. N Engl J Med 2002;347:1483-92.

Fagard RH. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc 2001;33:S484-92.

Whelton SP, Chin A, Xin X, He J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med 2002;136:493-503.

Thompson PD, Crouse SF, Goodpaster B, Kelley D, Moyna N, Pescatello L. The acute versus the chronic response to exercise. Med Sci Sports Exerc 2001;33:S438-45.

Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W. Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA 2003;290:1323-30.

Thompson PD, Buchner D, Pina IL, Balady GJ, Williams MA, Marcus BH, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the council on clinical cardiology (subcommittee on exercise, rehabilitation, and prevention) and the council on nutrition, physical activity, and metabolism (subcommittee on physical activity). Circulation 2003;107:3109-16.

Norton L. Vigorous physical activity for 40 days may reduce cardiovascular risk factors. Proceeding of 55th Annual Meeting 2008. American College of Sports Medicine.

Slentz CA, Houmard JA, Johnson JL, Bateman LA, Tanner CJ, McCartney JS, et al. Inactivity, exercise training and detraining, and plasma lipoproteins. STRRIDE: a randomized, controlled study of exercise intensity and amount. J Appl Physiol 2007;103:432-42.

Leung FP, Yung LM, Laher I, Yao X, Chen ZY, Huang Y. Exercise, vascular wall and cardiovascular diseases: an update (part 1). Sports Med 2008;38:1009-24.

Sakuta H, Suzuki T. Physical activity and selected cardiovascular risk factors in middle-aged male personnel of self-defense forces. Ind Health 2006;44:184-9.

Kodama S, Tanaka S, Saito K, Shu M, Sone Y, Onitake F, et al. Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis. Arch Intern Med 2007;167(10):999-1008.

Chapman MJ, Assmann G, Fruchart JC, Shepherd J, Sirtori C. Raising high-density lipoprotein cholesterol with reduction of cardiovascular risk: the role of nicotinic acid--a position paper developed by the European consensus panel on HDL-C. Curr Med Res Opin 2004;20:1253-68.

Brown BG, Zhao XQ, Chait A, Fisher LD, Cheung MC, Morse JS, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. New Engl J Med 2001;345:1583-92.

Gordon DJ, Rifkind BM. High-density lipoprotein--the clinical implications of recent studies. New Engl J Med 1989;321:1311-6.

Bansal S, Buring JE, Rifai N, Mora S, Sacks FM, Ridker PM. Fasting compared with no fasting triglycerides and risk of cardiovascular events in women. JAMA 2007;298:309-16.

Stacy TA, Egger A. Results of retrospective chart review to determine improvement in lipid goal attainment in patients treated by high-volume prescribers of lipid-modifying drugs. J Manag Care Pharm 2006;12:745-51.

Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: A meta-analysis of randomized controlled trials. Hypertension 2000;35:838-43.

Hua L, Brown CA, Hains S, Godwin M, Parlow J. Effects of low-intensity exercise conditioning on blood pressure, heart rate, and autonomic modulation of heart rate in men and women with hypertension. Biol Res Nurs 2010;12:137-148.

Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001;104:2746-53.

Emberson JR, Whincup PH, Morris RW, Wannamethee SG, Shaper AG. Lifestyle and cardiovascular disease in middle-aged British men: the effect of adjusting for within-person variation. Eur Heart J 2005;26:1774-82.

Hsu LL, Nevin RL, Tobler SK, Rubertone MV. Trends in overweight and obesity among 18-year-old applicants to the United States military, 1993-2006. J Adolesc Health 2007;41:610-2.

Basu S. Military not immune from obesity ‘Epidemic’. U.S. Medicine.[cited 2004 March25]. Available from: URL:http://www.usmedicine.com/dailyNews.cfm?dailyID=187.

Yung LM, Laher I, Yao X, Chen ZY, Huang Y, Leung FP. Exercise, vascular wall and cardiovascular diseases: an update (part 2). Sports Med 2008;39:45-63.

McTiernan A, Sorensen B, Irwin ML, Morgan A, Yasui Y, Rudolph RE, et al. Exercise effect on weight and body fat in men and women. Obesity (Silver Spring) 2007;15:1496-512.

Centers for Disease Control and Prevention (CDC). Prevalence of regular physical activity among adults-United States, 2001 and 2005. MMWR Morb Mortal Wkly Rep 2007;56:1209-12.

دانلود

چاپ شده

2011-11-27

شماره

نوع مقاله

مقاله پژوهشي

مقالات بیشتر خوانده شده از همین نویسنده

<< < 34 35 36 37 38 39 40 41 42 43 > >>