image: Systematic aerobic PA can exert a range of positive health effects on cardiovascular health by mitigating multiple pathogeneses associated with CVD. Primarily, it enhances metabolic health by improving insulin sensitivity and increasing energy expenditure, which are crucial for preventing and managing conditions like hypertension, hyperlipidemia, diabetes, and obesity. At the same time, it can also enhance the capacity and efficiency of the aerobic energy supply system, effectively improving CRF and the innate ability of muscles to extract and utilize oxygen from the blood. Evidence also suggests that regular aerobic PA can stimulate the development of coronary collateral blood vessels, increasing myocardial perfusion, and release exerkines that promote angiogenesis and vascularization, contributing to lowered BP and improved endothelial function, etc. It has also proven to play a major role in helping to promote cellular maintenance and repair processes. Collectively, these effects, in concert with other benefits including formulating a healthier metabolic milieu with attenuation of systemic chronic inflammation, adaptations at the vascular (antiatherogenic effects) and heart tissue (myocardial regeneration and cardioprotection) levels, as well as improvement in mitochondrial homeostasis, oxidative stress, autonomic balance and other risk factors, constitute the key biological basis for the role of aerobic PA in the prevention and treatment of CVD.
Credit: ©Science China Press
身体活动是改善心血管健康最容易实现且成本效益最高的途径之一。现有指南推荐，健康成年人每周应至少进行150–300分钟中等强度或75–150分钟高强度有氧身体活动，或二者等量组合，并辅以每周至少2天的肌肉强化身体活动。然而，目前少有研究系统阐述不同运动方式与心血管健康的特定关联及剂量反应关系。因此，刘芳超等人开展了这项系统综述，全面梳理不同类型身体活动心血管健康效应的现有证据，并探讨与各类型身体活动相关的心血管健康影响机制，旨在为促进心血管健康寻求更适宜和有效的运动方式时提供科学依据和参考。
该综述指出，有氧运动时间与心血管疾病风险之间存在非线性剂量-反应关系，在整个时长范围内均观察到显著的风险降低，且对缺乏运动的人群益处更大。客观测量数据显示，晚间进行有氧运动可能带来更大的健康获益；对于无法维持日常规律运动的人群，将身体活动集中至周末一两天（“周末战士”模式）同样能显著降低心血管风险。在肌肉强化身体活动方面，现有证据显示其时长与心血管风险呈“J”型关联，每周40-60分钟为最佳时长。然而，目前关于过高的肌肉强化活动是否存在潜在风险，仍需更多客观数据来验证。
值得注意的是，该综述强调了联合运动模式（有氧与肌肉强化相结合）在改善心血管健康方面的显著优势，其通过改善血流动力学、调节代谢及优化身体成分等途径发挥协同保护作用，从而更高效地促进心血管健康。
该综述特别指出，身体活动的心血管健康获益在已具有危险因素的人群中更为明显，但这类人群在追求更大获益的同时，必须关注身体活动的安全上限，在降低风险的同时尽量避免运动相关不良事件。该研究团队表示，未来应进一步利用客观测量数据深化机制研究，明确关键生物标志物，并通过人工智能与可穿戴技术的整合，构建智能个性化管理系统，推动心血管防治向精准干预转变。