Cardiorespiratory fitness and coronary artery calcification in young adults: The CARDIA Study

Abstract

Whether cardiorespiratory fitness relates to early subclinical atherosclerotic vascular disease remains unknown. We investigated the relation of cardiorespiratory fitness to coronary artery calcification (CAC) in 2373 African-American and White young adults from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. We measured cardiorespiratory fitness in 1985-1986 (baseline) using a symptom-limited exercise test on a treadmill. Coronary calcium scores were measured in 2001-2002 (year 15) using electron-beam or multi-detector computed tomography. CAC was classified as present or absent, while cardiorespiratory fitness was classified as sex-specific low, moderate, and high fitness categories. After adjustment for age, sex, race, clinical center, education, cigarette smoking, waist girth, alcohol intake, physical activity, systolic blood pressure, antihypertensive medication use, diabetes mellitus, and fasting insulin, baseline cardiorespiratory fitness was inversely associated with prevalence of CAC in young adults (P for trend = 0.03). The odds ratios of having CAC for persons in the moderately and highly fit individuals were 0.80 (95% confidence interval (CI), 0.55-1.15) and 0.59 (95% CI, 0.36-0.97), respectively, as compared with the low-fit individuals. High levels of cardiorespiratory fitness were associated with a lower risk of having coronary calcification 15 years later in African-American and White young adults.

Coronary Artery Calcification in the Asian Population: An Overview of the Results from the Korea Initiatives on Coronary Artery Calcification Registry

“…Furthermore, several prior studies have reported that cardiorespiratory fitness measured by treadmill test is inversely associated with CAC prevalence [57,58]. Nevertheless, whether there is a significant interaction between exercise capacity and CACS influencing adverse outcomes remains unclear.…”

Lifestyle Factors and Coronary Artery Calcification

“…The CARDIA study showed that physical fitness measured at baseline was inversely associated with early atherosclerotic vascular disease in young adults. High-fitness young adults (treadmill time: men ≥13.5 min, women ≥10 min; age 18-30 years) had a 41% lower risk of having CAC as compared with low-fitness counterparts (treadmill time: men <11 min, women <7.3 min) over 15 years [31]. One cross-sectional study showed a null association between physical fitness, as assessed by continuous metabolic equivalents (MET; 1 MET = 3.5 ml O 2 /kg/min), and CAC in US women aged 40-90 years [32].…”

“…Interestingly, several population-based studies indicate no association between physical activity and CAC. The Multi-Ethnic Study of Atherosclerosis (MESA) and the CARDIA study have shown that physical activity was not associated with CAC [31,33]. This may be due to the inaccurate measurement of physical activity in both cross-sectional and observational studies.…”

Physical Activity in Chronic Kidney Disease: a Plausible Approach to Vascular Calcification?

“…Among the 2,373 African-American and white young adults enrolled in the Coronary Artery Risk Development in Young Adults Study, baseline cardio-respiratory fitness was inversely related with the development of CAC during the subsequent 15 years of follow-up. Nonetheless, whether the main determinant of CAC deposition is the genetic background or PA of study subjects could not be addressed in the study [34]. …”