Relationship between aerobic fitness and progression of coronary atherosclerosis

Abstract

Cross-sectional data suggest that the degree of coronary atherosclerosis is associated with aerobic fitness. However, there are limited longitudinal data addressing whether aerobic fitness is a predictor of coronary atherosclerosis progression. This study investigated whether peak oxygen consumption is related to a longitudinal increase in coronary calcium scores. Study subjects were voluntary participants in a health screening program who underwent a cardiopulmonary function test and repeated coronary calcium scoring. Individuals with clinical cardiovascular disease were excluded. The final sample included 4843 subjects with 14,856 records. The treadmill exercise test was performed using a modified Bruce protocol and Agatston coronary artery calcium (CAC) scores were measured using multi-detector CT. The mean age of the participants was 52 ± 6 years and 4.7 % were female. In a multi-level mixed effect regression model, increased CAC scores over time were significantly less likely in individuals with a higher VO2peak after adjusting for age, gender, hypertension, HbA1c, smoking status and LDL cholesterol levels (p < 0.001). Aerobic fitness has a protective effect on the progression of coronary atherosclerosis in an asymptomatic middle-aged population.

Exercise and Coronary Atherosclerosis

“…18 Several Korean studies found an inverse association between cardiorespiratory fitness and CAC among mainly middle-aged men. [34][35][36] Similar results were found in middle-aged women from the Cooper Clinic, 37 however the observed modest inverse relationship between fitness and CAC was no longer significant after adjustment for traditional risk factors. In contrast, the CARDIA study (Coronary Artery Risk Development in Young Adults) found a positive association between cardiorespiratory fitness and CAC in young adults followed for 27 years, 38 which disappeared after multivariate adjustment.…”

Fitness attenuates the prevalence of increased coronary artery calcium in individuals with metabolic syndrome

“…12 In a prospective analysis of a larger sample of the same study cohort (median follow-up 3.6 years), the authors concluded that fitness had a protective effect on the progression of CAC even after adjustment for conventional risk factors at baseline. 31 Also, vigorous physical activity is shown to reduce incident CAC (going from CACS ¼ 0 at baseline to CACS > 0 at follow-up) after adjusting for traditional risk factors. Conversely, in a large sample of women (40-90 years old) detectable CAC and CACS !…”

Combined effects of physical exercise and education on age-related cortical thinning in cognitively normal individuals

“…Physical exercise was assessed using the modified Korean version of International Physical Activity Questionnaire 7 (IPAQ-7) 35 36 37 . The questionnaire was a subjective measure that asked participants to recall their physical activity from the previous 7 days.…”