Physical Activity and Reduced Risk of Cardiovascular Events

Abstract

Background-Higher levels of physical activity are associated with fewer cardiovascular disease (CVD) events. Although the precise mechanisms underlying this inverse association are unclear, differences in several cardiovascular risk factors may mediate this effect. Methods and Results-In a prospective study of 27 055 apparently healthy women, we measured baseline levels of hemoglobin A1c, traditional lipids (total, low-density lipoprotein, and high-density lipoprotein cholesterol), novel lipids [lipoprotein(a) and apolipoprotein A1 and B-100], creatinine, homocysteine, and inflammatory/hemostatic biomarkers (high-sensitivity C-reactive protein, fibrinogen, soluble intracellular adhesion molecule-1) and used women's selfreported physical activity, weight, height, hypertension, and diabetes. Mean follow-up was 10.9Ϯ1.6 years, and 979 incident CVD events occurred. The risk of CVD decreased linearly with higher levels of activity (P for linear trend Ͻ0.001). Using the reference group of Ͻ200 kcal/wk of activity yielded age-and treatment-adjusted relative risk reductions associated with 200 to 599, 600 to 1499, and Ն1500 kcal/wk of 27%, 32%, and 41%, respectively. Differences in known risk factors explained a large proportion (59.0%) of the observed inverse association. When sets of risk factors were examined, inflammatory/hemostatic biomarkers made the largest contribution to lower risk (32.6%), followed by blood pressure (27.1%). Novel lipids contributed less to CVD risk reduction compared with traditional lipids (15.5% and 19.1%, respectively). Smaller contributions were attributed to body mass index (10.1%) and hemoglobin A1c/diabetes (8.9%), whereas homocysteine and creatinine had negligible effects (Ͻ1%). Conclusions-The inverse association between physical activity and CVD risk is mediated in substantial part by known risk factors, particularly inflammatory/hemostatic factors and blood pressure.

Risk of Recurrent Stroke and Death After First Stroke in Long‐Distance Ski Race Participants

“…We know that various cardiovascular risk factors have a different impact on the various cardiovascular outcomes, and it is likely that the benefits of physical activity are also different. The potential mediating mechanisms for physical activity and lower risk for cardiovascular events have been studied in a large cohort study 21. Inflammatory, hemostatic biomarkers made the largest contribution to lower risk followed by blood pressure, lipids, body mass index, and hemoglobin A1c in diabetes.…”

Supervised walking groups to increase physical activity in elderly women with and without hypertension: effect on pulse wave velocity

“…Exercise may reduce cardiovascular (CV) morbidity and mortality 1 and decrease several CV risk factors. The beneficial effect of aerobic physical activity on CV risk factors has been reported even in the elderly.…”

Decrease of Lp(a) during weight reduction in obese children is modified by the apo(a) kringle-IV copy number variation

“…Several population and cross-sectional studies showed a lack of association between serum Lp(a) levels and regular moderate physical activity or moderate exercise training. [20][21][22][23][24]29 The few studies that found a beneficial effect of exercise on Lp(a) were either confounded by ethnical issues 25 or included only men. 26 Therefore, it appears likely that the changes in Lp(a) levels observed in our study were caused by the dietary intervention rather than by the increased physical activity.…”

“…18,19 Similarly, the effect of physical exercise on Lp(a) levels is not fully understood, with several contradicting reports. [20][21][22][23][24][25][26][27][28][29] Only few studies were performed in children. 27,28 In this study, we therefore tested the possibility of lowering Lp(a) levels by a weight reduction program during a 3-week dietary camp for obese children.…”