The Association of Physical Activity With Carotid Intima Media Thickening in a Healthy Older Population: Cooper Center Longitudinal Study

in Journal of Aging and Physical Activity
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The purpose of this study was to examine the association between self-reported physical activity (PA) and mean common carotid artery intima–media thickness (CCA IMT) among older adults. The data are from 1,811 Cooper Center Longitudinal Study participants, who were aged ≥60 years, with no history of cardiovascular disease. A medical history questionnaire was used to assess PA. Carotid ultrasound was performed to measure CCA IMT and the presence of plaque and stenosis. Logistic regression models were constructed to estimate the association between PA and CCA IMT after adjustment for covariates. The participants were aged 69.2 ± 5.9 years, and the majority were male (73.3%) and White (96.7%). The odds ratio of abnormal thickening of CCA IMT was 0.72 (95% confidence interval [0.54, 0.96]) in physically active participants (≥500 metabolic equivalent·min/week) after adjustment for covariates. In the current study, meeting PA guidelines in older adulthood was associated with lower odds of abnormal thickening of CCA IMT.

J. Lee, Kohl, and Gabriel are with the Department of Epidemiology, Human Genetics and Environmental Sciences, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHeath) at Houston School of Public Health in Austin, Austin, TX. Chen is with the Department of Biostatistics and Data Science, Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center (UTHealth) at Houston School of Public Health in Austin, Austin, TX. Kohl and Gabriel are also with the Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX. Barlow and DeFina are with the Cooper Institute, Dallas, TX. C. do Lee is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Radford is with Cooper Clinic, Dallas, TX. J. Lee is also with the Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA. Gabriel is also with the Department of Women’s Health Dell Medical School, The University of Texas at Austin, Austin, TX.

J. Lee (lee8690@bu.edu) is corresponding author.
  • Ainsworth, B.E., Haskell, W.L., Herrmann, S.D., Meckes, N., Bassett, D.R., Jr., Tudor-Locke, C., … Leon, A.S. (2011). 2011 Compendium of physical activities: A second update of codes and MET values. Medicine & Science in Sports & Exercise, 43(8), 1575–1581. PubMed ID: 21681120 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • American Diabetes Association. (2004). Diagnosis and classification of diabetes mellitus. Diabetes Care, 27, S5. doi:

  • Ascenso, A., Palmeira, A., Pedro, L.M., Martins, S., & Fonseca, H. (2016). Physical activity and cardiorespiratory fitness, but not sedentary behavior, are associated with carotid intima-media thickness in obese adolescents. European Journal of Pediatrics, 175(3), 391–398. PubMed ID: 26490566 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Auperin, A., Berr, C., Bonithon-Kopp, C., Touboul, P.-J., Ruelland, I., Ducimetiere, P., & Alperovitch, A. (1996). Ultrasonographic assessment of carotid wall characteristics and cognitive functions in a community sample of 59-to 71-year-olds. Stroke, 27(8), 1290–1295. PubMed ID: 8711788 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bertoni, A.G., Whitt-Glover, M.C., Chung, H., Le, K.Y., Barr, R.G., Mahesh, M., … Jacobs, D.R. (2009). The association between physical activity and subclinical atherosclerosis. American Journal of Epidemiology, 169(4), 444–454. PubMed ID: 19075250 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Blair, S.N., Kohl, H.W., Barlow, C.E., Paffenbarger, R.S., Gibbons, L.W., & Macera, C.A. (1995). Changes in physical fitness and all-cause mortality: A prospective study of healthy and unhealthy men. The Journal of the American Medical Association, 273(14), 1093–1098. PubMed ID: 7707596 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Blair, S.N., Kohl, H.W., Paffenbarger, R.S., Clark, D.G., Cooper, K.H., & Gibbons, L.W. (1989). Physical fitness and all-cause mortality: A prospective study of healthy men and women. The Journal of the American Medical Association, 262(17), 2395–2401. PubMed ID: 2795824 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bots, M.L., Evans, G.W., Riley, W., Meijer, R., McBride, K.H., Paskett, E.D., … OPAL Investigators. (2003). The Osteoporosis Prevention and Arterial effects of tiboLone (OPAL) study: Design and baseline characteristics. Controlled Clinical Trials, 24(6), 752–775. PubMed ID: 14662281 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Buse, J.B., Ginsberg, H.N., Bakris, G.L., Clark, N.G., Costa, F., Eckel, R., … Nesto, R.W. (2007). Primary prevention of cardiovascular diseases in people with diabetes mellitus: A scientific statement from the American Heart Association and the American Diabetes Association. Circulation, 115(1), 114–126. PubMed ID: 17192512 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Byrkjeland, R., Stensæth, K.-H., Anderssen, S., Njerve, I.U., Arnesen, H., Seljeflot, I., & Solheim, S. (2016). Effects of exercise training on carotid intima-media thickness in patients with type 2 diabetes and coronary artery disease. Influence of carotid plaques. Cardiovascular Diabetology, 15(1), 13. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Crouse, J.R., 3rd, Grobbee, D.E., O’Leary, D.H., Bots, M.L., Evans, G.W., Palmer, M.K., … METEOR Study Group. (2007). Carotid intima-media thickness in low-risk individuals with asymptomatic atherosclerosis: Baseline data from the METEOR study. Current Medical Research and Opinion, 23(3), 641–648. PubMed ID: 17355745 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Den Ruijter, H.M., Peters, S.A., Anderson, T.J., Britton, A.R., Dekker, J.M., Eijkemans, M.J., … Grobbee, D.E. (2012). Common carotid intima-media thickness measurements in cardiovascular risk prediction: A meta-analysis. The Journal of the American Medical Association, 308(8), 796–803. PubMed ID: 22910757 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Gamble, G., Beaumont, B., Smith, H., Zorn, J., Sanders, G., Merrilees, M., … Sharpe, N. (1993). B-mode ultrasound images of the carotid artery wall: Correlation of ultrasound with histological measurements. Atherosclerosis, 102(2), 163–173. PubMed ID: 8251002 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Green, D.J., Walsh, J.H., Maiorana, A., Best, M.J., Taylor, R.R., & O’Driscoll, J.G. (2003). Exercise-induced improvement in endothelial dysfunction is not mediated by changes in CV risk factors: Pooled analysis of diverse patient populations. American Journal of Physiology-Heart and Circulatory Physiology, 285(6), H2679–H2687. PubMed ID: 12933344 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Haskell, W.L., Lee, I.-M., Pate, R.R., Powell, K.E., Blair, S.N., Franklin, B.A., … Bauman, A. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1081–1093. PubMed ID: 17671237 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Inaba, Y., Chen, J.A., & Bergmann, S.R. (2012). Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: A meta-analysis. Atherosclerosis, 220(1), 128–133. PubMed ID: 21764060 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jiang, R., Schulze, M.B., Li, T., Rifai, N., Stampfer, M.J., Rimm, E.B., & Hu, F.B. (2004). Non-HDL cholesterol and apolipoprotein B predict cardiovascular disease events among men with type 2 diabetes. Diabetes Care, 27(8), 1991–1997. PubMed ID: 15277429 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kadoglou, N., Iliadis, F., & Liapis, C. (2008). Exercise and carotid atherosclerosis. European Journal of Vascular and Endovascular Surgery, 35(3), 264–272. PubMed ID: 17988901 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kadoglou, N.P., Perrea, D., Iliadis, F., Angelopoulou, N., Liapis, C., & Alevizos, M. (2007). Exercise reduces resistin and inflammatory cytokines in patients with type 2 diabetes. Diabetes Care, 30(3), 719–721. PubMed ID: 17327348 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kastelein, J.J., van Leuven, S.I., Evans, G.W., Riley, W.A., Revkin, J.H., Shear, C.L., … RADIANCE 1 and 2 Study Investigators. (2007). Designs of RADIANCE 1 and 2: Carotid ultrasound studies comparing the effects of torcetrapib/atorvastatin with atorvastatin alone on atherosclerosis. Current Medical Research and Opinion, 23(4), 885–894. PubMed ID: 17407645 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Knopman, D., Boland, L., Mosley, T., Howard, G., Liao, D., Szklo, M., … Folsom, A. (2001). Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology, 56(1), 42–48. PubMed ID: 11148234 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kwasniewska, M., Jegier, A., Kostka, T., Dziankowska-Zaborszczyk, E., Rebowska, E., Kozinska, J., & Drygas, W. (2014). Long-term effect of different physical activity levels on subclinical atherosclerosis in middle-aged men: A 25-year prospective study. PLoS One, 9(1), e85209. PubMed ID: 24465505 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lee, CD., Folsom, A.R., & Blair, S.N. (2003). Physical activity and stroke risk: A meta-analysis. Stroke, 34(10), 2475–2481. PubMed ID: 14500932 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lorenz, M.W., Polak, J.F., Kavousi, M., Mathiesen, E.B., Völzke, H., Tuomainen, T.P., … Kiechl, S. (2012). Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): A meta-analysis of individual participant data. The Lancet, 379(9831), 2053–2062. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Luedemann, J., Schminke, U., Berger, K., Piek, M., Willich, S.N., Döring, A., … Kessler, C. (2002). Association between behavior-dependent cardiovascular risk factors and asymptomatic carotid atherosclerosis in a general population. Stroke, 33(12), 2929–2935. PubMed ID: 12468793 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mancia, G., De Backer, G., Dominiczak, A., Cifkova, R., Fagard, R., Germano, G., … Laurent, S. (2007). 2007 Guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European Heart Journal, 28(12), 1462–1536. PubMed ID: 17562668

    • Search Google Scholar
    • Export Citation
  • Nordstrom, C.K., Dwyer, K.M., Merz, C.N.B., Shircore, A., & Dwyer, J.H. (2003). Leisure time physical activity and early atherosclerosis: The Los Angeles Atherosclerosis Study. The American Journal of Medicine, 115(1), 19–25. PubMed ID: 12867230 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Physical Activity Guidelines Advisory Committee. (2008). Physical activity guidelines advisory committee report, 2008. Washington, DC: US Department of Health and Human Services. A1–H14.

    • Search Google Scholar
    • Export Citation
  • Physical Activity Guidelines Advisory Committee. (2018). Physical activity guidelines advisory committee scientific report. Washington, DC: US Department of Health and Human Services.

    • Search Google Scholar
    • Export Citation
  • Ried-Larsen, M., Grøntved, A., Froberg, K., Ekelund, U., & Andersen, L.B. (2013). Physical activity intensity and subclinical atherosclerosis in Danish adolescents: The European Youth Heart Study: PA, CRF and, subclinical atherosclerosis. Scandinavian Journal of Medicine & Science in Sports, 23(3), e168–e177. PubMed ID: 23336399 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Roman, M.J., Naqvi, T.Z., Gardin, J.M., Gerhard-Herman, M., Jaff, M., & Mohler, E. (2006). Clinical application of noninvasive vascular ultrasound in cardiovascular risk stratification: A report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology. Journal of the American Society of Echocardiography, 19(8), 943–954. PubMed ID: 16880089 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosvall, M., Janzon, L., Berglund, G., Engström, G., & Hedblad, B. (2005). Incidence of stroke is related to carotid IMT even in the absence of plaque. Atherosclerosis, 179(2), 325–331. PubMed ID: 15777549 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sofi, F., Capalbo, A., Cesari, F., Abbate, R., & Gensini, G.F. (2008). Physical activity during leisure time and primary prevention of coronary heart disease: An updated meta-analysis of cohort studies. European Journal of Cardiovascular Prevention & Rehabilitation, 15(3), 247–257. PubMed ID: 18525378 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stein, J.H., Korcarz, C.E., Hurst, R.T., Lonn, E., Kendall, C.B., Mohler, E.R., … Post, W.S. (2008). Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: A consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force endorsed by the Society for Vascular Medicine. Journal of the American Society of Echocardiography, 21(2), 93–111. PubMed ID: 18261694 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stensland-Bugge, E., Bønaa, K.H., Joakimsen, O., & Njølstad, I. (2000). Sex differences in the relationship of risk factors to subclinical carotid atherosclerosis measured 15 years later: The Tromsø study. Stroke, 31(3), 574–581. PubMed ID: 10700488 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tanaka, H., Seals, D.R., Monahan, K.D., Clevenger, C.M., DeSouza, C.A., & Dinenno, F.A. (2002). Regular aerobic exercise and the age-related increase in carotid artery intima-media thickness in healthy men. Journal of Applied Physiology, 92(4), 1458–1464. PubMed ID: 11896010 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thompson, P.D., Buchner, D., Piña, I.L., Balady, G.J., Williams, M.A., Marcus, B.H., … Franklin, B. (2003). Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease. Arteriosclerosis, Thrombosis, and Vascular Biology, 23(8), e42–e49.

    • Search Google Scholar
    • Export Citation
  • Touboul, P.-J., Hennerici, M., Meairs, S., Adams, H., Amarenco, P., Bornstein, N., … Fatar, M. (2007). Mannheim carotid intima-media thickness consensus (2004–2006). Cerebrovascular Diseases, 23(1), 75–80. PubMed ID: 17108679 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wannamethee, S.G., & Shaper, A.G. (2001). Physical activity in the prevention of cardiovascular disease. Sports Medicine, 31(2), 101–114. PubMed ID: 11227978 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Watarai, T., Yamasaki, Y., Ikeda, M., Kubota, M., Kodama, M., Tsujino, T., … Hori, M. (1999). Insulin resistance contributes to carotid arterial wall thickness in patients with non-insulin-dependent-diabetes mellitus. Endocrine Journal, 46(5), 629–638. PubMed ID: 10670747 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wendelhag, I., Gustavsson, T., Suurküla, M., Berglund, G., & Wikstrand, J. (1991). Ultrasound measurement of wall thickness in the carotid artery: Fundamental principles and description of a computerized analysing system. Clinical Physiology, 11(6), 565–577. PubMed ID: 1769190 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wong, M., Edelstein, J., Wollman, J., & Bond, M.G. (1993). Ultrasonic-pathological comparison of the human arterial wall. Verification of intima-media thickness. Arteriosclerosis, Thrombosis, and Vascular Biology, 13(4), 482–486. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
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