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American Journal of Epidemiology Advance Access published online on December 15, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn350
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

The Association Between Physical Activity and Subclinical Atherosclerosis

The Multi-Ethnic Study of Atherosclerosis

Alain G. Bertoni, Melicia C. Whitt-Glover, Hyoju Chung, Katherine Y. Le, R. Graham Barr, Mahadevappa Mahesh, Nancy S. Jenny, Gregory L. Burke and David R. Jacobs

Correspondence to Dr. Alain G. Bertoni, Division of Public Health Sciences, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157 (e-mail: abertoni{at}wfubmc.edu).

Received for publication January 29, 2008. Accepted for publication October 3, 2008.

Prior reports regarding the association between physical activity and subclinical cardiovascular disease have not been consistent. The authors assessed physical activity and walking pace via questionnaire among 6,482 US adults aged 45–84 years without prior clinical cardiovascular disease participating in the Multi-Ethnic Study of Atherosclerosis from 2000 to 2002. Ankle-brachial index (ABI), coronary artery calcification, and internal and common carotid intima-media thickness (IMT) were measured. Metabolic equivalent-hours/week of physical activity were calculated. These data were analyzed by using multivariable linear or relative prevalence regression in gender-specific strata. After adjustment for age, race/ethnicity, clinic site, education, income, and smoking (model 1), increasing total, moderate + vigorous, and intentional-exercise physical activity were not associated with IMT or coronary artery calcification in either gender. These factors were associated with increased ABI (P < 0.05) in women only. Walking pace was associated favorably with common carotid IMT, ABI, and coronary artery calcification in men and with common carotid IMT and ABI in women (all P < 0.05) after adjustment for model 1 variables. These associations were attenuated and, for common carotid IMT, no longer significant when lipids, hypertension, diabetes, and body mass index were added to the model. These data suggest that walking pace is associated with less subclinical atherosclerosis; these associations may be mediated by cardiovascular disease risk factors.

atherosclerosis; carotid arteries; coronary vessels; exercise; motor activity; peripheral vascular diseases

Abbreviations: ABI, ankle-brachial index; CAC, coronary artery calcification; IMT, intima-media thickness; MESA, Multi-Ethnic Study of Atherosclerosis; MET, metabolic equivalent; TWPAS, Typical Week Physical Activity Survey


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