Scripties UMCG - Rijksuniversiteit Groningen
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The extend of physical activity of people in a rural area of North-West Germany and its relation to cardiovascular risk factors based on the ELITE-study

(2019) Dießelberg, C. (Chiara)

Background: Cardiovascular diseases remain the most common underlying cause of death worldwide. Physical activity is identified to reduce cardiovascular morbidity and mortality and various cardiovascular risk factors itself. Past studies only examined one additional risk factor and its relation, while mostly taking place in the US and Asia. Therefore, there is a re-search and data gap particularly in rural areas of North-West Europe respectively Germany.
Object: Aim is to confirm past studies on physical activity in relation to cardiovascular risk factors and fill the mentioned research and data gap. Therefore, the study is aimed to describe the amount of physical activity in the area of Lower-Saxony in Germany and detect the preva-lence of the separate risk factors within physical activity levels to analyse its relation.
Methods: This paper is an interim evaluation of an interventional cohort study (ELITE) in North-West Germany with voluntary participants aged >18 years. Basis data selection con-tained interviews, examinations, blood tests, and questionnaires. Data was evaluated descrip-tively, with physical activity being described through frequency, setting, type of sport, and average duration, thereby forming three physical activity levels (low, moderate, and high) based on the frequency. Within those activity levels the prevalence of the separate cardiovas-cular risk factors (in detail hypertension, diabetes mellitus, hypercholesterinaemia, overweight (BMI), nicotine abuse, stress, and unbalanced nutrition) and the total amount of cardiovascu-lar risk factors were compared and significances were proofed.
Results: The sample of this interim evaluation consists of 3005 voluntary study participants with a mean age of 54,5 (± 15,4). 58,2% of the participants are female. The study population covers all social classes. The most frequent reported risk factor is high blood pressure with 36,0% followed by the second most reported risk factor dyslipidaemia (19,1%). Most partici-pants are physically active two to three times per week. The high physical activity level con-tains 42%, while the moderate and the low level include 30% and 28% respectively. Mean average duration increases from low to high level (31, 44, and 113 minutes per week, respec-tively). However, physical activity of the sample falls below German average and participants mostly do not meet the recommendation regarding physical activity. Analysing the relation-ship between physical activity and the separate cardiovascular risk factors hypertension (p=<0,001), diabetes mellitus (p=0,001), nicotine abuse (p=<0,001), stress (p=<0,001), over-weight (p=<0,001), and unbalanced nutrition (high meat consumption: p=0,003; low fruit consumption: p=<0,001) show significant differences in prevalence comparing low to high physical activity group, while cholesterol (p=0,238) and cardiovascular diseases (p=0,846) do not. More specifically the prevalence of hypertension, diabetes mellitus, and nicotine abuse already decreases comparing the low to the moderate physical activity level. Looking at all cardiovascular risk factors combined, the study shows that participants with low physical ac-tivity have a significantly higher risk to have more than one risk factor at the same time com-pared to those with high physical activity levels.
Conclusion: Physical activity of the participants sampled falls below the German. Neverthe-less, even with physical activity being below recommendations study results show a signifi-cant relation of physical activity to the prevalence of the risk factors hypertension, diabetes mellitus, nicotine abuse, stress, overweight, and unbalanced nutrition. Furthermore, the total amount of cardiovascular risk factors seems to be positively influenced by physical activity. Physical activity might therefore be one of the most important and influential non-medical tools to compensate and reduce a variety of cardiovascular risk factors and their accumulative effect on the risk of cardiovascular diseases. The higher the physical activity, the less cardio-
vascular risk factors exist. Therefore, the study suggests this effect can already be seen be-tween levels of activity lower than recommendation. In conclusion recommendation should emphasize more that every little step is beneficial.

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