Associations of long-term physical activity trajectories with coronary artery calcium progression and cardiovascular disease events: results from the CARDIA study

Abstract

ObjectiveThe study aimed to assess the associations of physical activity (PA) trajectories across a 25-year span with coronary artery calcium (CAC) progression, and subsequent risk of cardiovascular disease (CVD) events.MethodsWe included 2497 participants from the Coronary Artery Disease Risk Development in Young Adults study who had computed tomography-assessment of CAC at baseline (year 15: 2000–2001) and follow-up (year 20 or 25) and at least three measures of PA from year 0 to year 25. Long-term PA trajectories were determined by latent class modelling using a validated questionnaire.ResultsAmong the included participants, 1120 (44.9%) were men, 1418 (56.8%) were white, and the mean (SD) age was 40.4 (3.6) years. We identified three distinct PA trajectories based on PA average levels and change patterns: low (below PA guidelines, n=1332; 53.3%); moderate (meeting and slightly over PA guidelines, n=919; 36.8%) and high (about three times PA guidelines or more, n=246; 9.9%). During a mean (SD) follow-up of 8.9 (2.1) years, 640 (25.6%) participants had CAC progression. Participants in the high PA trajectory group had a higher risk of CAC progression than those in the low PA trajectory group after adjustment for traditional cardiovascular risk factors (HR 1.51; 95% CI 1.18 to 1.94). However, high PA trajectory was not associated with an increased risk of incident CVD events (HR 1.01; 95% CI 0.44 to 2.31) and the incidence of CVD events in participants with CAC progression was similar across all three PA trajectory groups (p=0.736).ConclusionLong-term PA about three times the guidelines or more is independently associated with CAC progression; however, no additional risk of incident CVD events could be detected.

Coronary Plaque in Athletes

“…In 2021, both Sung Y. et al and Gao J.W. et al stratified subjects from previous trials depending on their amount of PA and demonstrated greater progression at the CCTA follow-up in terms of CAC score in groups with higher levels of PA [27,28]. These latter data, confirming those obtained on populations of athletes only by Aengevaeren V.L.…”

“…Afterwards in 2021, Gao J.W. and colleagues confirmed previous evidence about an association between progression of CAC and increased risk of cardiovascular events in the general population, but they pointed out that the risk did not vary depending on the amount of physical activity [28].…”

Epidemiology and current management of cardiovascular disease in China

“…During a median follow-up of 5 years, shift work was associated with increased risk of MACE. [71] Apart from shift work, physical activity (PA) is also associated with the risk of CVD. During a mean follow-up of 8.9 years, participants in the high PA trajectory group had a higher risk of coronary artery calcium progression than those in the low PA trajectory group.…”

COVID-19: Insights into long-term manifestations and lockdown impacts

“… 15 , 16 However, PA, which is defined as any bodily movement produced by skeletal muscles that results in energy expenditure, has been shown to be beneficial for cardiovascular health and to reduce the risk of CVDs. 8 , 13 , 14 , 17 , 18 , 19 , 20 , 21 , 22 , 23…”