Association between Physical Activity and Self-Rated Health Status in Populations with Different Cardiovascular and Cerebrovascular Disease Risk Levels
CHU Xiaoting, YANG Xiaoming, XIANG Yunjie, SHEN Yi, ZHANG Xin, CHEN Jiehua, CHEN Chuanying, HUANG Wei, FANG Jialie
2026, 21(4):
430-438.
DOI: 10.3969/j.issn.1673-5765.2026.04.005
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Objective To investigate the association between physical activity and self-rated health in populations with different cardiovascular and cerebrovascular disease risk levels, and to provide a scientific basis for precise health interventions.
Methods A cross-sectional study design was adopted. The 10-year risk of cardiovascular and cerebrovascular diseases was assessed using the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) model among participants aged 35-75 years in Jing’an District, Shanghai. They were divided into a low-to-moderate risk group (10-year cardiovascular and cerebrovascular disease risk<10%) and a high-risk group (10-year cardiovascular and cerebrovascular disease risk≥10%). Self-rated health status was evaluated using the EuroQol visual analogue scale (EQ-VAS). Data on physical activity (including leisure-time activity, household activity, transport activity, and total physical activity), sedentary time, screen time, and sleep time over the past seven days were collected using the long-form international physical activity questionnaire. Spearman rank correlation analysis was used to analyze the correlations between various physical activity indicators and the EQ-VAS score. Considering that total physical activity is a cumulative indicator of the three types of activities, and screen time can be regarded as an important component of sedentary time, four multivariate linear regression models (sedentary time+three types of activities, sedentary time+total physical activity, screen time+three types of activities, screen time+total physical activity) were constructed separately for the low-to-moderate risk and high-risk populations to explore the differential effects of individual activities versus cumulative activity, and the independent contributions of screen time versus total sedentary time. All models were adjusted for confounding factors such as gender, education level, alcohol consumption, chronic diseases, and BMI.
Results Using the China-PAR model, the 10-year risk of cardiovascular and cerebrovascular diseases was assessed among 2410 participants, identifying 2198 (91.20%) as low-to-moderate risk and 212 (8.80%) as high risk. There were 853 males (38.81%) in the low-to-moderate risk group and 189 males (89.15%) in the high-risk group, indicating a higher proportion of males in the high-risk group. Compared with the low-to-moderate risk group, the high-risk group exhibited lower EQ-VAS scores, older age, lower education levels, higher proportion of alcohol consumption, higher prevalence of chronic diseases, higher BMI, less household activity and total physical activity, and longer sleep time (all P<0.05), with no significant differences in other indicators. Spearman rank correlation analysis showed that transport activity was negatively correlated with EQ-VAS scores in the high-risk group (rs=-0.154, P=0.025). Multivariate linear regression analysis revealed that in the low-to-moderate risk group, chronic disease was negatively associated with EQ-VAS scores in the four models (β=-3.921 to -3.876, all P<0.001), while total physical activity was positively associated with EQ-VAS scores in Model 2 and Model 4 (β=0.377 to 0.381, all P<0.05). In the high-risk group, transport activity was negatively associated with EQ-VAS scores in Model 1 and Model 3 (β=-1.058 to -0.975, all P<0.05), while leisure-time activity in Model 1 and Model 3 (β=0.873 to 1.105, all P<0.05) and screen time in Model 3 and Model 4 (β=1.415 to 1.438, all P<0.05) were positively associated with EQ-VAS scores. Sleep duration was positively correlated with EQ-VAS scores only in Model 1 (β = 6.947, P = 0.038). Males were negatively associated with EQ-VAS scores in the four models (β=-6.242 to -5.517, all P<0.05).
Conclusions The association between physical activity and self-rated health exhibits significant heterogeneity across populations with different cardiovascular and cerebrovascular disease risk levels. In the low-to-moderate risk population, accumulation of total physical activity and chronic disease management play important roles in maintaining health. In the high-risk population, leisure-time activity and screen time are positively associated with self-rated health, while transport activity is negatively associated, and self-rated health is significantly poorer in males. The prevention and control of cardiovascular and cerebrovascular diseases should adopt differentiated intervention strategies based on population risk levels. For the high-risk population, attention should be paid to the complex effects of physical activity on self-rated health, and males should be prioritized as a key target group for interventions.
