TAYLOR, A. J., T. WATKINS, D. BELL, J. CARROW, J. BINDEMAN, D. SCHERR, I. FEUERSTEIN, H. WONG, S. BHATTARAI, M. VAITKUS, and P. G. O’MALLEY. Physical activity and the presence and extent of calcified coronary atherosclerosis. Med. Sci. Sports Exerc., Vol. 34, No. 2, pp. 228–233, 2002.
Purpose: 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.
Conclusion: 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.
Cardiology, General Internal Medicine, and Radiology Services, Walter Reed Army Medical Center, Washington, DC; Uniformed Services University of the Health Sciences, Bethesda MD; and Armed Forces Physical Fitness Research Institute, Carlisle, PA
Submitted for publication January 2001.
Accepted for publication May 2001.