Physical activity and the presence and extent of calcified coronary atherosclerosis.
OBJECTIVE
Regular physical activity leads to a more favorable cardiovascular risk factor profile and a lower risk of developing incident coronary heart disease (CHD). These correlations suggest that higher levels of physical activity should also attenuate the presence and extent of coronary atherosclerosis.


METHODS
Physical activity was measured using the Baecke Physical Activity Index in 630 consecutive asymptomatic men and women ages 39-45 without known heart disease. The degree of physical activity was compared with the cardiovascular risk factor profile and the presence and extent of subclinical atherosclerosis measured using electron beam computed tomography.


RESULTS
Sports-related physical activity was associated with lower body mass index (r = -0.11; P = 0.001), higher high-density lipoprotein (HDL) cholesterol (r = 0.13; P = 0.003) and less glucose resistance as assessed by fasting serum insulin levels (r = -0.16; P = 0.001). Leisure-time and work-related physical activity were unrelated to any coronary risk variables. Calcified subclinical atherosclerosis was unrelated to all physical activity dimensions. Comparing the most sedentary (lowest quartile) and most active (highest quartile) patients, the prevalence of coronary calcium (17.0% vs 18.5%; P = 0.92) and mean coronary calcium scores (8 +/- 31 vs 5 +/- 15; P = 0.87) were similar. In a multivariate model controlling for standard cardiovascular risk factors and physical activity level, only low-density lipoprotein (LDL) cholesterol was associated with the presence of coronary calcium.


CONCLUSIONS
Physical activity, particularly high-intensity exercise in sports-related activities, promotes a healthy cardiovascular risk profile, including lower body mass index and insulin resistance, but is unrelated to coronary calcification. This suggests that the risk reduction associated with physical activity is mediated by factors other than retarding the development of calcified atherosclerosis.
Taylor
Allen J
AJ
Cardiovascular Research, Cardiology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. allen.taylor@na.amedd.army.mil
Watkins
Tammy
T
Bell
Debbie
D
Carrow
Jon
J
Bindeman
Jody
J
Scherr
Diane
D
Feuerstein
Irwin
I
Wong
Henry
H
Bhattarai
Saroj
S
Vaitkus
Mark
M
O'Malley
Patrick G
PG
D000328:Adult; D000886:Anthropometry; D001794:Blood Pressure; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000378:metabolism; D015444:Exercise; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D013177:Sports / Q000706:statistics & numerical data; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology
D007328:Insulin; D002784:Cholesterol