Skip navigation

Fitness and atherosclerosis progression

Study
Results
Comment
Good cardiorespiratory fitness, usually a product of exercise, is associated with lower risks of bad things happening, like heart attacks, strokes, and other vascular events. One question unanswered till now has been the extent to which exercise and fitness slows the progression of atherosclerosis. A study from Finland [1] shows that it does in middle-aged men, a finding that again raises some questions about how much effort should be put into health promotion.

Study


This was a complicated study in some ways, and difficult to précis because of the very large number of measurements made. There were 854 men chosen randomly from the population of Kuopio in eastern Finland, and who were 42, 48, 54 or 60 years old between 1984 and 1989. Fitness was assessed using a maximum exercise test and measuring oxygen consumption (expressed as mL/kg/minute during maximum exercise). At about the same time carotid atherosclerosis was measured using ultrasound at the 1.5 cm distal end of the right and left common carotid artery. Four measures of atherosclerosis were used, and repeated four years later.

Results


Men with lower cardiorespiratory fitness at baseline had much higher levels of coronary heart disease, heart failure, stroke history, claudication asthma and diabetes than those who had high cardiorespiratory fitness.

Over four years men with higher fitness levels had significantly lower indices of atherosclerosis development than those with lower levels of fitness. After adjusting for factors like age, smoking and so on, the energy expenditure of conditioning physical activity and its frequency were associated with slower increase in carotid atherosclerosis. Conditioning physical activity was walking, jogging, cross county skiing, cycling, swimming, rowing, ball games, dancing or weightlifting.

Comment


One of the most interesting parts of this report was the discussion, because increasing maximum oxygen consumption is only partly a reflection of exercise undertaken. Other factors, including genetics, diet and weight all contribute. But there is little doubt that maximising fitness levels in middle-aged men is an important thing to do for a whole raft of reasons. It is likely that slowing atherosclerosis can be added to these. More and better sports facilities should be on somebody's shopping list.

References:

  1. 1 TA Lakka et al. Cardiorespiratory fitness and the progression of carotic atherosclerosis in middle-aged men. Annals of Internal Medicine 2001 134: 12-20.
previous story in this issue