Physical activity measured by accelerometry and its associations with cardiac structure and vascular function in young and middle-aged adults

Abstract

Background: Physical activity is associated with several health benefits, including lower cardiovascular disease risk. The independent influence of physical activity on cardiac and vascular function in the community, however, has been sparsely investigated.

Measures and results: We related objective measures of moderate- to vigorous-intensity physical activity (MVPA, assessed by accelerometry) to cardiac and vascular indices in 2376 participants of the Framingham Heart Study third generation cohort (54% women, mean age 47 years). Using multivariable regression models, we related MVPA to the following echocardiographic and vascular measures: left ventricular mass, left atrial and aortic root sizes, carotid-femoral pulse wave velocity, augmentation index, and forward pressure wave. Men and women engaged in MVPA 29.9±21.4 and 25.5±19.4 min/day, respectively. Higher values of MVPA (per 10-minute increment) were associated with lower carotid-femoral pulse wave velocity (estimate -0.53 ms/m; P=0.006) and lower forward pressure wave (estimate -0.23 mm Hg; P=0.03) but were not associated with augmentation index (estimate 0.13%; P=0.25). MVPA was associated positively with log(e) left ventricular mass (estimate 0.006 log(e) [g/m(2)]; P=0.0003), left ventricular wall thickness (estimate 0.07 mm; P=0.0001), and left atrial dimension (estimate 0.10 mm; P=0.01). MVPA also tended to be positively associated with aortic root dimension (estimate 0.05 mm; P=0.052). Associations of MVPA with cardiovascular measures were similar, in general, for bouts lasting <10 versus ≥10 minutes.

Conclusions: In our community-based sample, greater physical activity was associated with lower vascular stiffness but with higher echocardiographic left ventricular mass and left atrial size. These findings suggest complex relations of usual levels of physical activity and cardiovascular remodeling.

Keywords: echocardiography; epidemiology; physical activity; vascular measures.

Figure 1.

Adjusted splines of the association between MVPA in min/day (x‐axis) and different cardiovascular measures (y‐axis): A, CFPWV; B, log_e (LVM); C, aortic root dimension; and D, left atrial dimension. Knots were placed at MVPA 25th, 50th, and 75th percentiles (4.5, 23, 37 minutes). The y‐axis illustrates deviations from the quantity estimated at the middle knot value. CFPWV indicates carotid–femoral pulse wave velocity; LVM, left ventricular mass; MVPA, moderate‐ to vigorous‐intensity physical activity. The grey lines represent 95% confidence intervals.