The association of midlife cardiorespiratory fitness with later life carotid atherosclerosis: Cooper Center Longitudinal Study

Joowon Lee, Baojiang Chen, Harold W. Kohl, Carolyn E. Barlow, Chong Lee, Nina B. Radford, Laura F. DeFina, Kelley Pettee Gabriel

Research output: Contribution to journalArticle

Abstract

Background and aims: While numerous cross-sectional studies have demonstrated an inverse relationship between cardiorespiratory fitness (CRF) and carotid atherosclerosis in middle age, much less is known about the association of midlife CRF with carotid atherosclerosis in later life. Methods: We studied 1094 participants, free of cardiovascular disease, who completed a maximal exercise test (GXT) for an objective measure of CRF between ages 40 and 59 and carotid ultrasound after the age of 59, with at least five years between studies. Carotid intima media thickness was measured. Assessments were also made regarding the presence of plaque and percent stenosis in four regions: common carotid, bulb, internal carotid and external carotid arteries. Multivariable logistic regression models were constructed to estimate the association of CRF with carotid artery disease. Results: At the time of GXT and carotid scan, participants were aged 50.7 ± 5.7 years and 69.3 ± 6.4 years, respectively. Almost half of participants had high midlife CRF (48.6%); 41.3% and 10.1% had moderate and low CRF, respectively. Over a mean follow-up period of 18.6 ± 8.5 years, the odds of having carotid artery disease in later life in the high CRF group was 0.50 (95% CI: 0.29–0.87) compared with the low CRF group. Each 1 MET increase in CRF was associated with 10% lower odds of having carotid artery disease (OR = 0.89, 95% CI: 0.80–0.98). Conclusions: Midlife CRF was inversely associated with carotid artery disease measured almost two decades later. This may represent a mechanistic link between high midlife CRF and reduced risk of stroke in later life.

Original languageEnglish (US)
Pages (from-to)137-142
Number of pages6
JournalAtherosclerosis
Volume282
DOIs
StatePublished - Mar 1 2019

Fingerprint

Carotid Artery Diseases
Longitudinal Studies
Cardiorespiratory Fitness
Logistic Models
External Carotid Artery
Carotid Intima-Media Thickness
Exercise Test
Pathologic Constriction
Cardiovascular Diseases
Cross-Sectional Studies
Stroke

Keywords

  • Cardiorespiratory fitness
  • Carotid atherosclerosis
  • Carotid intima media thickness
  • Physical activity
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The association of midlife cardiorespiratory fitness with later life carotid atherosclerosis : Cooper Center Longitudinal Study. / Lee, Joowon; Chen, Baojiang; Kohl, Harold W.; Barlow, Carolyn E.; Lee, Chong; Radford, Nina B.; DeFina, Laura F.; Gabriel, Kelley Pettee.

In: Atherosclerosis, Vol. 282, 01.03.2019, p. 137-142.

Research output: Contribution to journalArticle

Lee, Joowon ; Chen, Baojiang ; Kohl, Harold W. ; Barlow, Carolyn E. ; Lee, Chong ; Radford, Nina B. ; DeFina, Laura F. ; Gabriel, Kelley Pettee. / The association of midlife cardiorespiratory fitness with later life carotid atherosclerosis : Cooper Center Longitudinal Study. In: Atherosclerosis. 2019 ; Vol. 282. pp. 137-142.
@article{e86c53ced8884e91a064c7efbb3365d4,
title = "The association of midlife cardiorespiratory fitness with later life carotid atherosclerosis: Cooper Center Longitudinal Study",
abstract = "Background and aims: While numerous cross-sectional studies have demonstrated an inverse relationship between cardiorespiratory fitness (CRF) and carotid atherosclerosis in middle age, much less is known about the association of midlife CRF with carotid atherosclerosis in later life. Methods: We studied 1094 participants, free of cardiovascular disease, who completed a maximal exercise test (GXT) for an objective measure of CRF between ages 40 and 59 and carotid ultrasound after the age of 59, with at least five years between studies. Carotid intima media thickness was measured. Assessments were also made regarding the presence of plaque and percent stenosis in four regions: common carotid, bulb, internal carotid and external carotid arteries. Multivariable logistic regression models were constructed to estimate the association of CRF with carotid artery disease. Results: At the time of GXT and carotid scan, participants were aged 50.7 ± 5.7 years and 69.3 ± 6.4 years, respectively. Almost half of participants had high midlife CRF (48.6{\%}); 41.3{\%} and 10.1{\%} had moderate and low CRF, respectively. Over a mean follow-up period of 18.6 ± 8.5 years, the odds of having carotid artery disease in later life in the high CRF group was 0.50 (95{\%} CI: 0.29–0.87) compared with the low CRF group. Each 1 MET increase in CRF was associated with 10{\%} lower odds of having carotid artery disease (OR = 0.89, 95{\%} CI: 0.80–0.98). Conclusions: Midlife CRF was inversely associated with carotid artery disease measured almost two decades later. This may represent a mechanistic link between high midlife CRF and reduced risk of stroke in later life.",
keywords = "Cardiorespiratory fitness, Carotid atherosclerosis, Carotid intima media thickness, Physical activity, Stroke",
author = "Joowon Lee and Baojiang Chen and Kohl, {Harold W.} and Barlow, {Carolyn E.} and Chong Lee and Radford, {Nina B.} and DeFina, {Laura F.} and Gabriel, {Kelley Pettee}",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.atherosclerosis.2019.01.009",
language = "English (US)",
volume = "282",
pages = "137--142",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - The association of midlife cardiorespiratory fitness with later life carotid atherosclerosis

T2 - Cooper Center Longitudinal Study

AU - Lee, Joowon

AU - Chen, Baojiang

AU - Kohl, Harold W.

AU - Barlow, Carolyn E.

AU - Lee, Chong

AU - Radford, Nina B.

AU - DeFina, Laura F.

AU - Gabriel, Kelley Pettee

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background and aims: While numerous cross-sectional studies have demonstrated an inverse relationship between cardiorespiratory fitness (CRF) and carotid atherosclerosis in middle age, much less is known about the association of midlife CRF with carotid atherosclerosis in later life. Methods: We studied 1094 participants, free of cardiovascular disease, who completed a maximal exercise test (GXT) for an objective measure of CRF between ages 40 and 59 and carotid ultrasound after the age of 59, with at least five years between studies. Carotid intima media thickness was measured. Assessments were also made regarding the presence of plaque and percent stenosis in four regions: common carotid, bulb, internal carotid and external carotid arteries. Multivariable logistic regression models were constructed to estimate the association of CRF with carotid artery disease. Results: At the time of GXT and carotid scan, participants were aged 50.7 ± 5.7 years and 69.3 ± 6.4 years, respectively. Almost half of participants had high midlife CRF (48.6%); 41.3% and 10.1% had moderate and low CRF, respectively. Over a mean follow-up period of 18.6 ± 8.5 years, the odds of having carotid artery disease in later life in the high CRF group was 0.50 (95% CI: 0.29–0.87) compared with the low CRF group. Each 1 MET increase in CRF was associated with 10% lower odds of having carotid artery disease (OR = 0.89, 95% CI: 0.80–0.98). Conclusions: Midlife CRF was inversely associated with carotid artery disease measured almost two decades later. This may represent a mechanistic link between high midlife CRF and reduced risk of stroke in later life.

AB - Background and aims: While numerous cross-sectional studies have demonstrated an inverse relationship between cardiorespiratory fitness (CRF) and carotid atherosclerosis in middle age, much less is known about the association of midlife CRF with carotid atherosclerosis in later life. Methods: We studied 1094 participants, free of cardiovascular disease, who completed a maximal exercise test (GXT) for an objective measure of CRF between ages 40 and 59 and carotid ultrasound after the age of 59, with at least five years between studies. Carotid intima media thickness was measured. Assessments were also made regarding the presence of plaque and percent stenosis in four regions: common carotid, bulb, internal carotid and external carotid arteries. Multivariable logistic regression models were constructed to estimate the association of CRF with carotid artery disease. Results: At the time of GXT and carotid scan, participants were aged 50.7 ± 5.7 years and 69.3 ± 6.4 years, respectively. Almost half of participants had high midlife CRF (48.6%); 41.3% and 10.1% had moderate and low CRF, respectively. Over a mean follow-up period of 18.6 ± 8.5 years, the odds of having carotid artery disease in later life in the high CRF group was 0.50 (95% CI: 0.29–0.87) compared with the low CRF group. Each 1 MET increase in CRF was associated with 10% lower odds of having carotid artery disease (OR = 0.89, 95% CI: 0.80–0.98). Conclusions: Midlife CRF was inversely associated with carotid artery disease measured almost two decades later. This may represent a mechanistic link between high midlife CRF and reduced risk of stroke in later life.

KW - Cardiorespiratory fitness

KW - Carotid atherosclerosis

KW - Carotid intima media thickness

KW - Physical activity

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=85060987578&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060987578&partnerID=8YFLogxK

U2 - 10.1016/j.atherosclerosis.2019.01.009

DO - 10.1016/j.atherosclerosis.2019.01.009

M3 - Article

C2 - 30731286

AN - SCOPUS:85060987578

VL - 282

SP - 137

EP - 142

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

ER -