{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:49:33Z","timestamp":1792608573811,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,2]]},"abstract":"\n Background<\/jats:title>\n \n Physical activity (\n PA<\/jats:styled-content>\n ), particularly outdoor\n PA<\/jats:styled-content>\n , may have dual effects on cardiovascular disease (\n CVD<\/jats:styled-content>\n ) risk: health benefits of exercise and potential harmful effects attributable to increased exposure to air pollution. We examined the combined effects of\n PA<\/jats:styled-content>\n and air pollution on\n CVD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Sampling from a nationwide cohort study of the Korean National Health Insurance Service, we examined 189\u00a0771 adults aged \u226540 years who underwent health examination between 2009 and 2010.\n PA<\/jats:styled-content>\n was measured with a questionnaire on the weekly frequency and intensity. Ambient levels of particulate matter 10, 2.5 (\n PM<\/jats:styled-content>\n 10,\n PM<\/jats:styled-content>\n 2.5) were estimated by the residency of participants. We conducted Cox proportional hazard regression analysis to estimate the relationship between\n CVD<\/jats:styled-content>\n risk and combined effects of\n PA<\/jats:styled-content>\n and air pollution. Subjects with moderate to vigorous\n PA<\/jats:styled-content>\n \u22655 times\/week and high\n PM<\/jats:styled-content>\n 10 exposure had lower risk of\n CVD<\/jats:styled-content>\n (adjusted hazard ratio [aHR], 0.73; 95%\n CI<\/jats:styled-content>\n , 0.62\u20130.87), coronary heart disease (aHR, 0.76; 95%\n CI<\/jats:styled-content>\n , 0.59\u20130.98), and stroke (aHR, 0.70; 95%\n CI<\/jats:styled-content>\n , 0.56\u20130.88). The inverse association between\n PA<\/jats:styled-content>\n and\n CVD<\/jats:styled-content>\n risk was consistent when the analysis was performed for subjects with low\/moderate\n PM<\/jats:styled-content>\n 10 exposure. When using\n PM<\/jats:styled-content>\n 2.5 data, the results were also consistent.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Moderate to vigorous\n PA<\/jats:styled-content>\n appeared to reduce the risk of\n CVD<\/jats:styled-content>\n within groups of both high and low\n PM<\/jats:styled-content>\n 10 or\n PM<\/jats:styled-content>\n 2.5 levels. Further studies are needed to validate whether the health benefits of\n PA<\/jats:styled-content>\n outweigh the potential harmful effects resulting from increased exposure to air pollution during\n PA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.013611","type":"journal-article","created":{"date-parts":[[2020,5,23]],"date-time":"2020-05-23T11:20:33Z","timestamp":1590232833000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["Combined Effects of Physical Activity and Air Pollution on Cardiovascular Disease: A\u00a0Population\u2010Based Study"],"prefix":"10.1161","volume":"9","author":[{"given":"Seong Rae","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Medicine Seoul National University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seulggie","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NaNa","family":"Keum","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA"},{"name":"Department of Food Science and Biotechnology Dongguk University Goyang South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Min","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea"},{"name":"Department of Family Medicine Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32152-9"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000075572.40158.77"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e31829e3dda"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr112"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjr.0000198923.80555.b7"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph121114887"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054409"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.9.1132"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa0805646"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy607"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu458"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181dbece1"},{"key":"e_1_3_1_14_2","first-page":"799","article-title":"Data resource profile: the National Health Information Database of the National Health Insurance Service in South Korea","volume":"46","author":"Cheol Seong S","year":"2017","unstructured":"Cheol Seong S, Kim YY, Khang YH, Heon Park J, Kang HJ, Lee H, Do CH, Song JS, Hyon Bang J, Ha S, et\u00a0al. 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