Physical activity associated with progression of coronary artery calcification

By Ahmed El-Medany

This prospective study by Sung et al assessed the relationship between physical activity (PA) and the development of coronary artery calcification (CAC). Interestingly, the researchers identified a correlation between PA and the prevalence and the progression of CAC, regardless of baseline CAC scores.25,485 participants, free of overt cardiovascular disease, were included. Baseline PA was measured using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and categorised into three groups (inactive, moderately active, and health-enhancing physically active (HEPA)). The primary outcome was the difference in the 5-year change in CAC scores by PA category at baseline.

The proportions of participants who were inactive, moderately active and HEPA were 46.8%, 38.0%, and 15.2%, respectively. The estimated adjusted average baseline CAC scores (95% confidence intervals) in participants who were inactive, moderately active and HEPA were 9.45 (8.76, 10.14), 10.20 (9.40, 11.00) and 12.04 (10.81, 13.26), respectively.

Compared with inactive participants, the estimated adjusted 5-year average increase in CAC scores in moderately active and HEPA participants were 3.20 (0.72, 5.69) and 8.16 (4.80, 11.53).The researchers state: ‘Engaging in physical activity may accelerate the progression of CAC, possibly due to plaque healing, stabilisation and calcification’.

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Source: Sung KC, Hong YS, Lee JY, Lee SJ, Chang Y, Ryu S, Zhao D, Cho J, Guallar E, Lima JA. Physical activity and the progression of coronary artery calcification. Heart. 2021 Aug 26