摘要：This paper summarizes the evidence on the relationship between physical activity (PA) and cardiovascular disease (CVD) that has been published mainly during the past 10 years. The primary focus is on aspects related to the primary prevention of the clinical events of coronary heart disease and stroke. The material was collected by conducting a search of the Medline, Embase and Cochrane electronic databases to identify systematic reviews and meta-analyses having been published on the relationship between PA and CVD since 2002. The terms used for the exposure were physical activity or exercise, and for the outcome the following terms: cardiovascular disease, coronary heart disease, coronary artery disease, coronary disease, myocardial infarction, stroke, peripheral vascular disease or peripheral arterial disease. In addition, committee reports on the topic were identified through scientific meetings and by personal communication. A large majority of the studies included in the reviews were prospective cohort studies of at-risk populations. The quantity and quality of scientific data on the cardiovascular and other health-related effects of physical activity has increased greatly during the past decade. The evidence now shows convincingly that insufficient physical activity is one of the key causal risk factors of CVD, particularly of the most prevalent of them, CHD and stroke. The effects of insufficient physical activity are mediated partly through the traditional major risk factors, and partly they are independent. This rather recently shown fact emphasizes the essential, irreplaceable role of PA for cardiovascular health. Strong epidemiological evidence indicates that a major part of the preventive effect of PA can be attained by activity that is applicable on a large scale in all European populations: moderate-intensity endurance or aerobic activity such as brisk walking on several days during the week, in total approximately 150 minutes per week. Higher, still attainable amounts of moderate-intensity PA would further increase the CV and other health benefits, particularly because PA in all domains, during leisure time, in domestic chores, in transport, and in occupational work has been shown to be effective. Prevention of CVD through increased PA brings also several other health benefits by decreasing substantially the risk of several of the most common chronic diseases and by improving and maintaining physical, mental, and cognitive functions. PA also decreases, even totally counterbalances in overweight persons the risk of CVD, as well as several other health hazards of being overweight and obese. It is clear that sufficient physical activity is an essential factor in attaining and maintaining health and functional capacity at all ages, and without sufficient physical activity all attempts to improve the health of the Europeans remain deficient.
