Physicians' Academy for Cardiovascular Education

Physical activity in childhood pays off for arterial health in adulthood

Literature - Pälve et al, J Am Heart Assoc. 2014 - J Am Heart Assoc. 2014 Apr 22;3(2):e000594

 

Association of physical activity in childhood and early adulthood with carotid artery elasticity 21 years later: the cardiovascular risk in Young Finns Study

 
Pälve KS, Pahkala K, Magnussen CG, et al.
J Am Heart Assoc. 2014 Apr 22;3(2):e000594. doi: 10.1161/JAHA.113.000594
 

Background

Decreased arterial elasticity, as occurs with age, is a risk factor for several cardiovascular outcomes such as hypertension, atherosclerosis and coronary heart disease. It has been shown that high levels of habitual physical activity is associated with increased arterial elasticity in older adults [1-3]. The effect of physical activity in children and young adults on future vascular health is less clear.
Habitual physical activity in adults has been shown to be associated to increased insulin sensitivity, a more favourable lipid profile, decreased prevalence of the metabolic syndrome, and lower blood pressure and a lower risk of developing hypertension. These aspects may favourably influence arterial wall structure and function [4-6].
This study examined the effect of physical activity in children and young adults on carotid artery elasticity 21 years later. Data from over 2000 individuals from the prospective Cardiovascular Risk in Young Finns Study were used.
Ultrasound and concomitant brachial blood pressure measurements were used to calculate different indices of arterial elasticity: carotid artery distensibility (Cdist [%/10 mm Hg]), Young’s elastic modulus (YEM [kPa]), and stiffness index [SI]). Higher levels of both the YEM and SI represent decreased arterial elasticity, while a higher Cdist value represents a better arterial elasticity.
 

Main results

  • In 9- to 15- year old males, physical activity was significantly positively associated with adult Cdist, and inversely with adult YEM and SI. Multivariate analyses showed that physical activity remained a significant determinant of adult Cdist, YEM and SI after correction for covariates.
    In females of the same age, no significant relationships were found between physical activity and carotid artery indices of elasticity  in adulthood.
  • In young adults (18-24 years), physical activity was directly associated with future Cdist and inversely with YEM and SI. Physical activity in young adulthood proved to be a significant determinant of arterial elasticity 21 years later.
  • No significant relationships were seen between physical activity and elasticity after 15 years in both age groups.
  • In 9- to 15-year old males and females, and 18- to 24- year old young adults, no association was found between physical activity and carotid adult intima media thickness.
 
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Conclusion

These data show that physical activity in children and young adults is independently associated with increased carotid artery elasticity, which reflects arterial health, at age 30 to 45 years. No relationship was observed between physical activity at young age and carotid intima media thickness in adulthood. This study highlights the potential importance of being physically active already in childhood, to obtain maximal cardiovascular health.
 
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References

1. Moreau KL, Donato AJ, Seals DR et al. Regular exercise, hormone replacement therapy and the age-related decline in carotid arterial compliance in healthy women. Cardiovasc Res. 2003;57:861–868.
2. Nualnim N, Barnes JN, Tarumi T, et al. Comparison of central artery elasticity in swimmers, runners, and the sedentary. Am J Cardiol.2011;107:783–787.
3. Gando Y, Yamamoto K, Murakami H, et al. Longer time spent in light physical activity is associated with reduced arterial stiffness in older adults. Hypertension. 2010;56:540–546.
4. Koivistoinen T, Hutri-K€ah€onen N, Juonala M, et al. Metabolic syndrome in childhood and
increased arterial stiffness in adulthood: the Cardiovascular Risk in Young Finns Study. Ann Med. 2011;43:312–319.
5. Mattsson N, Magnussen CG, R€onnemaa T, et al. Metabolic syndrome and carotid intima-media thickness in young adults: roles of apolipoprotein B, apolipoprotein A-I, C-reactive protein, and secretory phospholipase A2: the Cardiovascular Risk in Young Finns study. Arterioscler Thromb Vasc Biol. 2010;30:1861–1866.
6. Juonala M, Viikari JS, K€ah€onen M, et al. Life-time risk factors and progression of carotid atherosclerosis in young adults: the Cardiovascular Risk in Young Finns study. Eur Heart J. 2010;31:1745–1751.
 

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