Higher CAC with higher physical activity doesn’t translate to higher mortality

  • JAMA Cardiol

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Men who engage in high levels of physical activity tend to have elevated coronary artery calcification (CAC) scores, but they do not have increased mortality at a decade of follow-up.

Why this matters

  • Some evidence points to higher CAC scores with physical activity exceeding 1 hour a day.
  • Commentary: “very high doses of running and exercise can be performed safely and heavily, even with hearts of stone.”

Key results

  • Men who had high physical activity (≥3000 metabolic equivalent of task [MET] minutes/week) and CAC
    • HR, 0.52 (95% CI, 0.29-0.91).
  • CAC of ≥100 and ≥3000 MET minutes/week had no increased mortality risk vs
    • HR, 0.77 (95% CI, 0.52-1.15).
  • In men with lowest activity, CAC of ≥100 had doubled cardiovascular mortality risk:
    • HR, 1.93 (95% CI, 1.34-2.78).

Study design

  • Prospective, observational study of 21,758 men (age, 51.7 [standard deviation, 8.4] years).
  • Funding: National Space Biomedical Research Institute.

Limitations

  • Homogeneous population.

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