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      Burden of ischemic heart disease mortality attributable to physical inactivity in Brazil

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          ABSTRACT

          OBJECTIVE

          To analyze if the burden of ischemic heart disease mortality trend attributed to physical inactivity in Brazil differs from the global estimates.

          METHODS

          Databases from the Global Burden of Disease Study for Brazil, Brazilian states, and global information were used. We estimated the summary exposure value for physical inactivity, the total number of deaths, and the age-standardized death rates for ischemic heart disease attributed to physical inactivity in the years 1990 and 2015, and the population-attributable fraction. Data were presented according to sex.

          RESULTS

          The Brazilian population was found to have a risk of exposure to physical inactivity varying between 70.4% for men and 75.7% for women in the year of 1990. This risk of exposure was similar in 2015. In men, the mortality rate from ischemic heart disease attributed to physical inactivity decreased in 2015 by approximately 24% around the world and 45% in Brazil. For women, this decrease was in 31% around the world and 45% in Brazil. The states of Southern and Southeastern Brazil presented lower mortality rates due to ischemic heart disease attributed to physical inactivity. If physical inactivity were eliminated in Brazil, mortality from ischemic heart disease would be reduced by 15.8% for men and 15.2% for women.

          CONCLUSIONS

          Over 25 years, the risk of exposure to physical inactivity in Brazil did not change and was high compared to global estimates. The decrease in ischemic heart disease mortality results from the improvement of health services in Brazil and the control of other risk factors. Approximately 15% of deaths from ischemic heart disease in Brazil could be avoided if people met the recommendations for physical activity.

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          Most cited references19

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          Dose response between physical activity and risk of coronary heart disease: a meta-analysis.

          No reviews have quantified the specific amounts of physical activity required for lower risks of coronary heart disease when assessing the dose-response relation. Instead, previous reviews have used qualitative estimates such as low, moderate, and high physical activity. We performed an aggregate data meta-analysis of epidemiological studies investigating physical activity and primary prevention of CHD. We included prospective cohort studies published in English since 1995. After reviewing 3194 abstracts, we included 33 studies. We used random-effects generalized least squares spline models for trend estimation to derive pooled dose-response estimates. Among the 33 studies, 9 allowed quantitative estimates of leisure-time physical activity. Individuals who engaged in the equivalent of 150 min/wk of moderate-intensity leisure-time physical activity (minimum amount, 2008 U.S. federal guidelines) had a 14% lower coronary heart disease risk (relative risk, 0.86; 95% confidence interval, 0.77 to 0.96) compared with those reporting no leisure-time physical activity. Those engaging in the equivalent of 300 min/wk of moderate-intensity leisure-time physical activity (2008 U.S. federal guidelines for additional benefits) had a 20% (relative risk, 0.80; 95% confidence interval, 0.74 to 0.88) lower risk. At higher levels of physical activity, relative risks were modestly lower. People who were physically active at levels lower than the minimum recommended amount also had significantly lower risk of coronary heart disease. There was a significant interaction by sex (P=0.03); the association was stronger among women than men. These findings provide quantitative data supporting US physical activity guidelines that stipulate that "some physical activity is better than none" and "additional benefits occur with more physical activity."
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            Physical Activity and Risk of Cardiovascular Disease—A Meta-Analysis of Prospective Cohort Studies

            In order to update and improve available evidence on associations of physical activity (PA) with cardiovascular disease (CVD) by applying meta-analytic random effects modeling to data from prospective cohort studies, using high quality criteria of study selection, we searched the PubMed database from January 1980 to December 2010 for prospective cohort studies of PA and incident CVD, distinguishing occupational PA and leisure time PA, coronary heart disease (CHD) and stroke, respectively. Inclusion criteria were peer-reviewed English papers with original data, studies with large sample size (n ≥ 1,000) and substantial follow-up (≥5 years), available data on major confounders and on estimates of relative risk (RR) or hazard ratio (HR), with 95% confidence intervals (CI). We included 21 prospective studies in the overall analysis, with a sample size of more than 650,000 adults who were initially free from CVD, and with some 20,000 incident cases documented during follow-up. Among men, RR of overall CVD in the group with the high level of leisure time PA was 0.76 (95% CI 0.70–0.82, p < 0.001), compared to the reference group with low leisure time PA, with obvious dose-response relationship. A similar effect was observed among women (RR = 0.73, 95% CI 0.68–0.78, p < 0.001). A strong protective effect of occupational PA was observed for moderate level in both men (RR = 0.89, 95% CI 0.82–0.97, p = 0.008) and women (RR = 0.83, 95% CI 0.67–1.03, p = 0.089). No publication bias was observed. Our findings suggest that high level of leisure time PA and moderate level of occupational PA have a beneficial effect on cardiovascular health by reducing the overall risk of incident coronary heart disease and stroke among men and women by 20 to 30 percent and 10 to 20 percent, respectively. This evidence from high quality studies supports efforts of primary and secondary prevention of CVD in economically advanced as well as in rapidly developing countries.
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              The relationship between sedentary behaviour and physical activity in adults: a systematic review.

              To ascertain, through a systematic review, the associations between sedentary behaviour (SB) and physical activity (PA) among adults aged 18-60years. Studies published in English up to and including June 2013 were located from computerized and manual searches. Studies reporting on at least one measure of SB and an association with one measure of PA were included. 26 studies met the inclusion criteria. Six studies examined associations between SB and PA prospectively, and 20 were cross-sectional. The most commonly assessed subtype of sedentary behaviours were television viewing (11 studies), total sedentary time (10), total sitting time (4), general screen time (3) and occupational sedentary time (2). All studied types of SB were associated with lower levels of PA in adults. Findings of this review suggest inverse associations between SB and PA were weak to moderate. Objective monitoring studies reported larger negative associations between SB and light intensity activity. Current evidence, though limited, supports the notion that sedentary behaviour displaces light intensity activity. Copyright © 2014 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                2018
                13 July 2018
                : 52
                : 72
                Affiliations
                [I ]Universidade Federal de Santa Catarina. Núcleo de Pesquisa em Cineantropometria e Desempenho Humano. Florianópolis, SC, Brasil
                [II ]Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
                [III ]Ministério da Saúde. Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde. Brasília, DF, Brasil
                [IV ]University of Washington. Institute for Health Metrics and Evaluation. Seattle, WA, United States
                Author notes
                Correspondence: Diego Augusto Santos Silva. Departamento de Educação Física – Centro de Desportos Universidade Federal de Santa Catarina, Campus Universitário – Trindade, Caixa Postal 476, 88040-900 Florianópolis, SC, Brasil. E-mail: diegoaugustoss@ 123456yahoo.com.br

                Authors’ Contribution: Design and planning of the study: DASS, DCM, MFMS, MN. Collection, analysis, and interpretation of the data: DASS, DCM, MFMS, MN. Preparation or review of the study: DASS. Approval of the final version: DASS, DCM, MFMS, MN. Public responsibility for the content of the article: DASS, DCM, MFMS, MN.

                Conflict of Interest: The authors declare no conflict of interest.

                Article
                00264
                10.11606/S1518-8787.2018052000413
                6063711
                30066811
                3219fd11-c0f3-4d7f-ab00-3c146fb89d00

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 August 2017
                : 22 December 2017
                Page count
                Figures: 3, Tables: 2, Equations: 2, References: 26, Pages: 1
                Categories
                Original Article

                sedentary lifestyle,global burden of disease,cardiovascular diseases, mortality,motor activity

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