The association between physical activity and both incident coronary artery calcification and ankle brachial index progression: The Multi-Ethnic Study of Atherosclerosis

Abstract

Objective Both coronary artery calcification (CAC) and the ankle brachial index (ABI) are measures of subclinical atherosclerotic disease. The influence of physical activity on the longitudinal change in these measures remains unclear. To assess this we examined the association between these measures and self-reported physical activity in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods At baseline, the MESA participants were free of clinically evident cardiovascular disease. We included all participants with an ABI between 0.90 and 1.40 (n=5656). Predictor variables were based on self-reported measures with physical activity being assessed using the Typical Week Physical Activity Survey from which metabolic equivalent-minutes/week of activity were calculated. We focused on physical activity intensity, intentional exercise, sedentary behavior, and conditioning. Incident peripheral artery disease (PAD) was defined as the progression of ABI to values below 0.90 (given the baseline range of 0.90 to 1.40). Incident CAC was defined as a CAC score >0 Agatston units upon follow up with a baseline score of 0 Agatston units. Results Mean age was 61 years, 53% were female, and mean body mass index was 28 kg/m2. After adjusting for traditional cardiovascular risk factors and socioeconomic factors, intentional exercise was protective for incident peripheral artery disease (Relative Risk (RR)= 0.85, 95% Confidence Interval (CI): 0.74 to 0.98). After adjusting for traditional cardiovascular risk factors and socioeconomic factors, there was a significant association between vigorous PA and incident CAC (RR=0.97, 95% CI: 0.94 to 1.00). There was also a significant association between sedentary behavior and increased amount of CAC among participants with CAC at baseline (Δlog(Agatston Units +25)=0.027, 95% CI 0.002, 0.052). Conclusions These data suggest that there is an association between physical activity/sedentary behavior and the progression of two different measures of subclinical atherosclerotic disease.

High Parathyroid Hormone Level and Osteoporosis Predict Progression of Coronary Artery Calcification in Patients on Dialysis

“…This is a novel finding in patients with CKD-5D but in agreement with results in subjects without CKD. 31 Use of DXA for measurement of BMD has been considered of limited usefulness for patients with CKD. 32,33 This was mostly related to the occurrence of extraosseous calcifications that might be included in the measurement results.…”

Pathophysiology of Intermittent Claudication in Peripheral Artery Disease

“…35 Lower physical activity also predicts progression of PAD with greater decline in the ABI over time. 36 Thus, therapeutic approaches that restore functional capacity in patients with PAD may have a wide-ranging health-promoting effect.…”

Lower functional capacity is associated with higher cardiovascular risk in Brazilian patients with intermittent claudication

“…The results of the Multi-Ethnic Study of Atherosclerosis suggested that sedentary behavior can increase the progression of coronary disease once it is present and that any type of activity is better than sedentary behavior for patients with early coronary artery disease. 18 Compared with participants with mild and moderate cardiovascular risk, those with severe cardiovascular risk were able to cover shorter distances during the 6-minute walk test, although a significant difference was only observed for the total distances covered by men. Previous studies demonstrated that self-reported ability to walk using the Walking Impaired Questionnaire (WIQ) was associated with or predicted cardiovascular mortality.…”