Association of the Amount and Pattern of Physical Activity With Arterial Stiffness: The Maastricht Study

Abstract

Background Arterial stiffness is an independent risk factor for cardiovascular disease and can be beneficially influenced by physical activity. However, it is not clear how an individual’s physical activity pattern over a week is associated with arterial stiffness. Therefore, we examined the associations of the amount and pattern of higher intensity physical activity with arterial stiffness. Methods and Results Data from the Maastricht Study (n=1699; mean age: 60±8 years, 49.4% women, 26.9% type 2 diabetes mellitus) were used. Arterial stiffness was assessed by carotid‐to‐femoral pulse wave velocity and carotid distensibility. The amount (continuous variable as h/wk) and pattern (categorical variable) of higher intensity physical activity were assessed with the activPAL3. Activity groups were: inactive (<75 min/wk), insufficiently active (75–150 min/wk), weekend warrior (>150 min/wk in ≤2 sessions), and regularly active (>150 min/wk in ≥3 sessions). In the fully adjusted model (adjusted for demographic, lifestyle, and cardiovascular risk factors), higher intensity physical activity was associated with lower carotid‐to‐femoral pulse wave velocity (amount: β = −0.05, 95% CI, −0.09 to −0.01; insufficiently active: β = −0.33, 95% CI, −0.55 to −0.11; weekend warrior: β = −0.38, 95% CI, −0.64 to −0.12; and regularly active: β = −0.46, 95% CI, −0.71 to −0.21 [reference: inactive]). These associations were stronger in those with type 2 diabetes mellitus. There was no statistically significant association between higher intensity physical activity with carotid distensibility. Conclusions Participating in higher intensity physical activity was associated with lower carotid‐to‐femoral pulse wave velocity, but there was no difference between the regularly actives and the weekend warriors. From the perspective of arterial stiffness, engaging higher intensity physical activity, regardless of the weekly pattern, may be an important strategy to reduce the risk of cardiovascular disease, particularly in individuals with type 2 diabetes mellitus.

Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study

“…Similarly, and in agreement with the results of this study, the benefit of physical activity on arterial stiffness was only achieved when its intensity was high [14,15,47,48]. Similarly, the recent study by Vandercappellen et al [13] reported that practicing intense physical activity was associated with lower arterial stiffness, detecting no differences among different exercise patterns; thus, they concluded that, from the perspective of arterial stiffness, performing intense physical activity, regardless of the weekly pattern conducted, can be an important strategy to reduce the risk of cardiovascular disease. Moreover, the effects on arterial stiffness vary depending on the modality of physical activity performed.…”

“…However, depending on the intensity and type of physical activity, and sex, its effect on arterial stiffness may vary. Thus, Vandercappellen et al [ 13 ] examined the association of the amount and pattern of intense physical activity with arterial stiffness in the Maastricht study. They reported that while a negative association between intense physical activity and arterial stiffness was found, this was not the case with regular or weekend physical activity.…”

“…However, depending on its intensity and type, the effect of physical activity on arterial stiffness is still controversial. Thus, some authors propose that the benefit is only obtained with exercises of moderate-high intensity, and that such benefit can vary depending on the type of exercise performed [13][14][15] and by sex [16]. Arterial stiffness is associated with the appearance of vascular aging [17,18], reflecting the dissociation between chronological age and biological age of the main arteries, with their alteration preceding the appearance of cardiovascular events [17][18][19].…”

Objectively measured adherence to physical activity among patients with coronary artery disease: Comparison of the 2010 and 2020 World Health Organization guidelines and daily steps

“…It is questionable whether PA of very short duration has the same beneficial effects on patients with CVD as structured exercise. Several mechanisms may explain the known benefits associated with PA in patients with CVD, including endothelial function improvement ( 42 , 43 ) and antiatherosclerotic ( 43 , 44 ) and anti-inflammatory ( 45 ) effects. Traditional risk factors for CHD such as diabetes, hypertension, smoking, and hypercholesterolemia are associated with endothelial dysfunction, which in turn results in impaired nitric oxide production, abnormal vasoconstriction, chronic inflammation, and increased oxidative stress ( 46 ).…”

Association of Physical Activity with Aortic Disease in Japanese Men and Women: The Japan Collaborative Cohort Study

“…Physical activity could reduce the risk of aortic diseases because it has a beneficial effect on cardiovascular risk factors such as hypertension and arterial stiffness as well as an anti-inflammatory effect [17][18][19][20][21] . A previous meta-analysis of prospective studies suggested that higher levels of physical activity were associated with a reduced risk of aortic diseases; however, only five of nine studies showed no association, and three of five studies did not adjust for major confounders such as smoking, obesity, and hypertension 22) .…”