title: Physical activity in older subjects is associated with increased coronary vasodilation: the ADVANCE study.
abstract: OBJECTIVE
  We investigated the association between physical activity and coronary vasodilation to nitroglycerin (NTG) in the ADVANCE (Atherosclerotic Disease, Vascular Function, and Genetic Epidemiology) cohort of older healthy subjects.
  
  
  BACKGROUND
  Physical activity may exert its beneficial effects by augmenting coronary responsiveness to nitric oxide. The relationship between physical activity and coronary vasodilatory response to NTG, an exogenous nitric oxide donor, has not been studied in a community-based population with typical activity levels.
  
  
  METHODS
  In 212 older adults (ages 60 to 72 years) without cardiovascular disease, we measured the coronary vasodilatory response to NTG using magnetic resonance angiography and physical activity using the Stanford Seven-Day Physical Activity Recall Questionnaire. The primary predictor measure was total physical activity (kcal/kg/day). The primary outcome measure was coronary vasodilatory response (percent increase of cross-sectional area post-NTG).
  
  
  RESULTS
  Coronary vasodilation was 27.6% in more active subjects (>35 kcal/kg/day, e.g., 1 h of walking per day) compared to 18.9% in less active subjects (p=0.03). Regression analysis showed a significant positive correlation between coronary vasodilation and physical activity (p=0.003), with a slope (beta) of 1.2% per kcal/kg/day. This finding remained significant after adjustment for cardiac risk factors, coronary calcium, the use of vasoactive or statin medications, and analysis of physical activity by quintiles (p < 0.05). Coronary vasodilation was also associated with physical activity intensity (p = 0.03).
  
  
  CONCLUSIONS
  In an asymptomatic, community-based cohort of older adults, increased coronary vasodilatory response was independently associated with greater physical activity, supporting the benefits of exercise on the order of 1 h of walking per day.
authors.affiliation: Stanford University School of Medicine, Cardiovascular Medicine, Stanford, California 94305, USA. pnguyen@cvmed.stanford.edu
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Nguyen
authors.forename: Masahiro
authors.initials: M
authors.lastname: Terashima
authors.forename: Joan M
authors.initials: JM
authors.lastname: Fair
authors.forename: Ann
authors.initials: A
authors.lastname: Varady
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Taylor-Piliae
authors.forename: Carlos
authors.initials: C
authors.lastname: Iribarren
authors.forename: Alan S
authors.initials: AS
authors.lastname: Go
authors.forename: William L
authors.initials: WL
authors.lastname: Haskell
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hlatky
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Fortmann
authors.forename: Michael V
authors.initials: MV
authors.lastname: McConnell
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging; D002140:California; D016009:Chi-Square Distribution; D003326:Coronary Circulation / Q000187:drug effects; D003331:Coronary Vessels / Q000187:drug effects / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D020030:Nitric Oxide Donors / Q000008:administration & dosage; D005996:Nitroglycerin / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D020030:Nitric Oxide Donors; D014665:Vasodilator Agents; D005996:Nitroglycerin