Research on Physical Activity and Coronary Artery Calcium Progression

Research conducted in China has shown that long-term physical activity (PA) about three times the guidelines or more is independently associated with the progression of coronary artery calcium (CAC). However, the researchers found no additional risk of incident cardiovascular disease (CVD) events. The study was published in the British Journal of Sports Medicine.

The researchers reported, "after adjusting for traditional cardiovascular risk factors, people in the high physical activity trajectory group had a higher risk of CAC progression versus those in the low activity trajectory group. The high physical activity trajectory group was not tied to an increased risk of incident cardiovascular events."

The study was conducted by Jing-Wei Gao, Sun Yat-sen University, Guangzhou, China, and colleagues with the aim to assess the associations of PA trajectories across a 25-year span with CAC progression and subsequent risk of cardiovascular disease (CVD) events.

For this purpose, the researchers included 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. Latent class modelling using a validated questionnaire determined long-term PA trajectories.

Among the included participants:

• 1120 (44.9%) were men
• 1418 (56.8%) were white
• The mean age was 40.4 years

Findings of the Study

The authors 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%)
• High (about three times PA guidelines or more, n=246; 9.9%)

During a mean follow-up of 8.9 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). High PA trajectory was not associated with an increased risk of incident CVD events (HR 1.01), and the incidence of CVD events in participants with CAC progression was similar across all three PA trajectory groups.

To conclude, "long-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."

Reference

Gao J, Hao Q, Lu L, et al. Associations of long-term physical activity trajectories with coronary artery calcium progression and cardiovascular disease events: results from the CARDIA study. British Journal of Sports Medicine Published Online First: 14 March 2022. doi: 10.1136/bjsports-2021-105092