Page 782 - Cardiac Nursing

2
009
0
6
009
2:0
4 A
1
2:0
68.
qx
3-7
68.
d
0
/
3
0
A
Pa
e 7
M
M
5
ara
ara
8
Apt
A
A
A
A
A
A
A
A
A
K34
K34
0-c
p7
32_
LWBK340-c32_p7553-768.qxd 30/06/2009 12:04 AM Page 758 Aptara
LWB K34 0-c 32_ p7 5 3-7 68. qx d 3 0 / 0 6 / / 2 009 1 2:0 4 A M Pa g g e 7 5 8 Apt ara
LWB
758 PA R T V / Health Promotion and Disease Prevention
aged 18 years and older participated in at least some light to mod-
PHYSICAL ACTIVITY erate leisure-time physical activity lasting 10 minutes or more per
4
session. Thus, a large proportion of the American public could be
The roles of physical activity and physicalfitness in preventing car- targeted for public health interventions to increase physical activity.
diovascular disease and controlling cardiovascular disease riskfac- Studies of the effects on cardiovascular disease of both on-the-job
tors are well established. In 2007, the American College of Sports and leisure-time activity indicate that in general, people who are
Medicine and the American Heart Association recommended that more physically active or physically fit tend to have CHD less often
“all healthy adults aged 18 to 65 years need moderate-intensity than sedentary or less fit people. CHD tends to be less severe and
aerobic physical activity for a minimum of 30 minutes on five days occurs at a later age among those who are physically active com-
each week or vigorous-intensity aerobic activity for a minimum of pared with those who are sedentary. 56 When data from cohort
20 minutes on three days each week.” 54 Data analyzed using the studies of occupational physical activity and CHD risk were
1996 Surgeon General’s Report on Physical Activity recommen- pooled, the risk for CHD death for those with low-level occupa-
dations (at least 30 minutes of moderate-intensity physical activ- tional activity was almost twice that of those with high-level ac-
ity on most days of the week) (Figs. 32-5 and 32-6) show that tivity, and the MI risk was 40% higher in the sedentary group. 57
only approximately half of all white women andless than 40% of In studies that included women, the risk for angina pectoris,
black and Mexican-American women are physically active four or MI, and sudden death was two to three times higher among
more times per week, andfewer than 25% of women walk at least women with the lowest compared with the highest activity level. 58
four times per week. The proportions are only slightly higher for An important addition to understanding the benefits of fitness has
American men. Data from the BRFSS for the periodfrom 1994 been made by studies that measure physical fitness using stan-
to 2004 demonstrate that the prevalence ofleisure-time physical dardized exercise tests and then compare fitness with later cardio-
inactivity overall declined significantly from 29.8% in 1994 to vascular outcomes. 59–62 In these studies, a higher level of fitness
23.7% in 2004. 55 However,based on data from the National was associated with a significantly lower rate of cardiovascular dis-
Health Interview Survey for 1999 to 2004, only 62% of adults ease mortality in men and women, 59,62 all-cause mortality in men
Women
Caucasian African-American Mexican-American
70
60
Percent doing physical activity ≥ 4 times/week 40
50
30
20
10
■ Figure 32-5 Prevalence of physical activity at least
0
20–29 30–39 40–49 50–59 60–69 70+ four times per week among U.S. women (A) and men (B)
by age and race/ethnicity. Physical activity: walking, jog-
A Age
ging or running, bicycling, swimming, aerobics, dancing,
calisthenics, garden/yard work, and/or lifting weights.
Men
(From National Center for Health Statistics. National
Caucasian African-American Mexican-American Health and Nutrition Examination Survey, III, 1988–1994.)
70
60
Percent doing physical activity ≥ 4 times/week 40
50
30
20
10
0
20–29 30–39 40–49 50–59 60–69 70+
B Age