Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study

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Abstract

Background

The purpose of the study was to examine the association between leisure-time physical activity (LTPA), cardiovascular biomarkers and atherosclerosis among asymptomatic men with stable LTPA level throughout the 25-year prospective observation.

Methods

Out of 101 asymptomatic men prospectively observed for their lifestyle and cardiovascular risk factors, the cohort of 62 individuals (mean age 59.9 years) maintained a stable LTPA level during the 25-year observation. Regular check-ups with the assessment of traditional risk factors, detailed measurements of LTPA level and aerobic capacity were performed since baseline. At the latest follow-up (2011/12) a set of cardiovascular biomarkers was measured using enzyme-linked immunosorbent assay. Subclinical atherosclerosis was assessed by means of coronary artery calcification score and intima-media thickness (IMT). Endothelial function was evaluated by means of the reactive hyperemia index. The studied biomarkers and indices were analyzed in the three cohorts representing stable low-tomoderate (<2050 kcal/week), high (2050-3840 kcal/week) and very high LTPA (>3840 kcal/week).

Results

At baseline the three cohorts were comparable in terms of age and clinical characteristics. At follow-up, the cohort with stable high LTPA (2050-3840 kcal/week) had significantly lower concentrations of hs-CRP (2.20 ± 1.0 mg/L), oxidized-LDL (68.35 ± 67.7 ng/mL), leptin (4.71 ± 3.07 ng/mL) and irisin (0.47 ± 0.13 μmol/L), and the most favorable indices of atherosclerosis and endothelial function as compared with other groups ( p < 0.05). Regular marathon runners had increased concentrations of hsCRP (3.12 ± 1.4 mg/L), oxidized-LDL (249.8 ± 129 ng/ml), Interleukine-6 (3.74 ± 2.4 pg/ml). A positive correlation was observed between hsCRP and IMT ( r = 0.301; p < 0.01), and irisin and IMT ( r = 0.223; p < 0.05).

Conclusions

The data suggest that stable high LTPA (2050-3840 kcal/week) is associated with the most favorable profile of key cardiovascular biomarkers and indices of atherosclerosis. Lifetime very high LTPA is associated with increased lowgrade inflammation and may, therefore, exert an atherogenic effect.

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Most cited references 42

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Physical Activity and Public Health: Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association

William Haskell, I-Min Lee, Russell R. Pate … (2007)

In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by an expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in pertinent physiologic, epidemiologic, and clinical scientific data, including primary research articles and reviews published since the original recommendation was issued in 1995. Issues considered by the panel included new scientific evidence relating physical activity to health, physical activity recommendations by various organizations in the interim, and communications issues. Key points related to updating the physical activity recommendation were outlined and writing groups were formed. A draft manuscript was prepared and circulated for review to the expert panel as well as to outside experts. Comments were integrated into the final recommendation. To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on three days each week. [I (A)] Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30-min minimum by performing bouts each lasting 10 or more minutes. [I (B)] Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate. In addition, every adult should perform activities that maintain or increase muscular strength and endurance a minimum of two days each week. [IIa (A)] Because of the dose-response relation between physical activity and health, persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities or prevent unhealthy weight gain may benefit by exceeding the minimum recommended amounts of physical activity. [I (A)]

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C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis

George Davey Smith (2010)

Summary Background Associations of C-reactive protein (CRP) concentration with risk of major diseases can best be assessed by long-term prospective follow-up of large numbers of people. We assessed the associations of CRP concentration with risk of vascular and non-vascular outcomes under different circumstances. Methods We meta-analysed individual records of 160 309 people without a history of vascular disease (ie, 1·31 million person-years at risk, 27 769 fatal or non-fatal disease outcomes) from 54 long-term prospective studies. Within-study regression analyses were adjusted for within-person variation in risk factor levels. Results Loge CRP concentration was linearly associated with several conventional risk factors and inflammatory markers, and nearly log-linearly with the risk of ischaemic vascular disease and non-vascular mortality. Risk ratios (RRs) for coronary heart disease per 1-SD higher loge CRP concentration (three-fold higher) were 1·63 (95% CI 1·51–1·76) when initially adjusted for age and sex only, and 1·37 (1·27–1·48) when adjusted further for conventional risk factors; 1·44 (1·32–1·57) and 1·27 (1·15–1·40) for ischaemic stroke; 1·71 (1·53–1·91) and 1·55 (1·37–1·76) for vascular mortality; and 1·55 (1·41–1·69) and 1·54 (1·40–1·68) for non-vascular mortality. RRs were largely unchanged after exclusion of smokers or initial follow-up. After further adjustment for fibrinogen, the corresponding RRs were 1·23 (1·07–1·42) for coronary heart disease; 1·32 (1·18–1·49) for ischaemic stroke; 1·34 (1·18–1·52) for vascular mortality; and 1·34 (1·20–1·50) for non-vascular mortality. Interpretation CRP concentration has continuous associations with the risk of coronary heart disease, ischaemic stroke, vascular mortality, and death from several cancers and lung disease that are each of broadly similar size. The relevance of CRP to such a range of disorders is unclear. Associations with ischaemic vascular disease depend considerably on conventional risk factors and other markers of inflammation. Funding British Heart Foundation, UK Medical Research Council, BUPA Foundation, and GlaxoSmithKline.

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Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms.

Samia Mora, Nancy Cook, Julie Buring … (2007)

Higher levels of physical activity are associated with fewer cardiovascular disease (CVD) events. Although the precise mechanisms underlying this inverse association are unclear, differences in several cardiovascular risk factors may mediate this effect. In a prospective study of 27,055 apparently healthy women, we measured baseline levels of hemoglobin A1c, traditional lipids (total, low-density lipoprotein, and high-density lipoprotein cholesterol), novel lipids [lipoprotein(a) and apolipoprotein A1 and B-100], creatinine, homocysteine, and inflammatory/hemostatic biomarkers (high-sensitivity C-reactive protein, fibrinogen, soluble intracellular adhesion molecule-1) and used women's self-reported physical activity, weight, height, hypertension, and diabetes. Mean follow-up was 10.9+/-1.6 years, and 979 incident CVD events occurred. The risk of CVD decreased linearly with higher levels of activity (P for linear trend or = 1500 kcal/wk of 27%, 32%, and 41%, respectively. Differences in known risk factors explained a large proportion (59.0%) of the observed inverse association. When sets of risk factors were examined, inflammatory/hemostatic biomarkers made the largest contribution to lower risk (32.6%), followed by blood pressure (27.1%). Novel lipids contributed less to CVD risk reduction compared with traditional lipids (15.5% and 19.1%, respectively). Smaller contributions were attributed to body mass index (10.1%) and hemoglobin A1c/diabetes (8.9%), whereas homocysteine and creatinine had negligible effects (< 1%). The inverse association between physical activity and CVD risk is mediated in substantial part by known risk factors, particularly inflammatory/hemostatic factors and blood pressure.

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Author and article information

Contributors

Magdalena Kwaśniewska: magdalena.kwasniewska@umed.lodz.pl

Tomasz Kostka: tomasz.kostka@umed.lodz.pl

Anna Jegier: anna.jegier@umed.lodz.pl

Elżbieta Dziankowska-Zaborszczyk: elzbieta.dziankowska-zaborszczyk@umed.lodz.pl

Joanna Leszczyńska: joanna.leszczynska@umed.lodz.pl

Milena Orczykowska: mil233@wp.pl

Wojciech Drygas: wojciech.drygas@umed.lodz.pl

Journal

Journal ID (nlm-ta): BMC Cardiovasc Disord

Journal ID (iso-abbrev): BMC Cardiovasc Disord

Title: BMC Cardiovascular Disorders

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2261

Publication date (Electronic): 5 April 2016

Publication date PMC-release: 5 April 2016

Publication date Collection: 2016

Volume: 16

Electronic Location Identifier: 65

Affiliations

[ ]Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland

[ ]Department of Geriatrics, Medical University of Lodz, Lodz, Poland

[ ]Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland

[ ]Department of Epidemiology and Biostatistics, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland

[ ]Central Clinical Hospital, Medical University of Lodz, 92-213 Lodz, Poland

[ ]Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland

Article

Publisher ID: 239

DOI: 10.1186/s12872-016-0239-x

PMC ID: 4820971

PubMed ID: 27044376

SO-VID: d0310525-0fe0-4809-9080-2c00ec59c94f

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 30 September 2015

Date accepted : 28 March 2016

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004281, Narodowe Centrum Nauki;

Award ID: NN 404 258940

Award Recipient : Wojciech Drygas

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ScienceOpen disciplines: Cardiovascular Medicine

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Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study

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Cardiovascular Innovations and Applications

Most cited references 42

Physical Activity and Public Health: Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association

C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis

Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms.

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