Physical Activity, Vitamin D, and Incident Atherosclerotic Cardiovascular Disease in Whites and Blacks: The ARIC Study.
Physical activity (PA) is associated with 25-hydroxyvitamin D [25(OH)D] levels. Both are associated with atherosclerotic cardiovascular disease (ASCVD), but their joint association with ASCVD risk is unknown.



To examine the relationship between PA and 25(OH)D, and assess effect modification of 25(OH)D and PA with ASCVD.



Cross-sectional and prospective study.



Community-dwelling cohort.



A total of 10,342 participants free of ASCVD, with moderate- to vigorous-intensity PA assessed (1987 to 1989) and categorized per American Heart Association (AHA) guidelines (recommended, intermediate, or poor).



Serum 25(OH)D levels (1990 to 1992) and ASCVD events (i.e., incident myocardial infarction, fatal coronary disease, or stroke) through 2013.



Participants had mean age of 54 years, and were 57% women, 21% black, 30% 25(OH)D deficient [<20 ng/mL (<50 nmol/L)], and <40% meeting AHA-recommended PA. PA was linearly associated with 25(OH)D levels in whites. Whites meeting recommended PA were 37% less likely to have 25(OH)D deficiency [relative risk, 0.63 (95% confidence interval [CI], 0.56, 0.71)]; there was no significant association in blacks. Over 19.3 years of follow-up, 1800 incident ASCVD events occurred. Recommended PA was associated with reduced ASCVD risk [hazard ratio [HR], 0.78 (95% CI, 0.65, 0.93) and 0.76 (95% CI, 0.62, 0.93)] among participants with intermediate [20 to <30 ng/mL (50 to <75 nmol/L)] and optimal [≥30 ng/mL (≥75 nmol/L)] 25(OH)D, respectively, but not among those with deficient 25(OH)D (P for interaction = 0.04).



PA is linearly associated with higher 25(OH)D levels in whites. PA and 25(OH)D may have synergistic beneficial effects on ASCVD risk.
Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, and.
Kathleen
K
Chin
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21287.
Di
D
Zhao
Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, and.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21287.
Martin
M
Tibuakuu
Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, and.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21287.
Seth S
SS
Martin
Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, and.
Chiadi E
CE
Ndumele
Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, and.
Roberta
R
Florido
Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi 39216.
B Gwen
BG
Windham
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21287.
Eliseo
E
Guallar
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55454.
Pamela L
PL
Lutsey
Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Johns Hopkins University School of Medicine, and.|Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21287.
Erin D
ED
Michos
D050197:Atherosclerosis / Q000097:blood* / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D044383:Black People / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data*
D014807:Vitamin D