Effects of Aerobic Physical Exercise on Inflammation and Atherosclerosis in Men: The DNASCO Study

A Six-Year Randomized, Controlled Trial

15 June 2004 | Volume 140 Issue 12 | Pages 1007-1014

Background: Although regular physical activity is recommended for prevention of cardiovascular diseases, no data are available on its antiatherosclerotic effects in the general population.

Objective: To determine whether progressive aerobic exercise compared with usual activity slows progression of atherosclerosis in men.

Design: A 6-year randomized, controlled trial.

Setting: Eastern Finland.

Participants: 140 middle-aged men randomly selected from the population registry.

Intervention: Low- to moderate-intensity aerobic exercise.

Measurements: Atherosclerosis was quantitated ultrasonographically as the mean intima–media thickness in the carotid artery at baseline and at years 2 through 6.

Results: On the basis of intention-to-treat analyses, a 19.5% net increase (P < 0.001) in ventilatory aerobic threshold was evident in the exercise group after 6 years. High-sensitivity C-reactive protein levels were statistically nonsignificantly lower in the exercise group than in the control group (P > 0.2). The progression of intima–media thickness in the carotid artery did not differ between the study groups (P > 0.2). A subgroup analysis that excluded men taking statins showed that the 6-year progression of intima–media thickness, adjusted for smoking and annual measures of low-density lipoprotein cholesterol level, systolic blood pressure, and waist circumference, was 40% less in the exercise group (0.12 mm [95% CI, –0.010 to 0.26 mm]) than in the control group (0.20 mm [CI, 0.05 to 0.35 mm]).

Limitations: Only middle-aged white men were included. The intervention included mainly aerobic exercises.

Conclusions: Aerobic physical exercise did not attenuate progression of atherosclerosis, except in a subgroup of men not taking statins.

Editors' Notes Context Few data address whether exercise slows progression of atherosclerosis. Contribution In this 6-year trial, middle-aged Finnish men were randomly assigned to progressive aerobic exercise or usual activity. Progressive exercise targeted 45- to 60-minute sessions 5 times weekly of activities such as walking, jogging, or cycling. Exercisers improved their ventilatory aerobic threshold and decreased their resting heart rate. However, intima–media thickness of the carotid artery measured by ultrasonography did not differ between groups, except in a subgroup of men not taking statins. Implications Aerobic exercise did not slow progression of atherosclerosis in middle-aged men, except for those not taking statins. –The Editors

 

Author and Article Information

From Kuopio Research Institute of Exercise Medicine, University of Kuopio, and Kuopio University Hospital, Kuopio, Finland; University of Freiburg, Freiburg, Germany; and Louisiana State University, Baton Rouge, Louisiana.

Grant Support: By the Ministry of Education in Finland (322/722/94, 80/722/95, 176/722/96, 42/722/97, 84/722/98, 138/722/99, 112/722/2000); Academy of Finland (68103/1999, 72401/2000); City of Kuopio; Finnish Heart Association; Juho Vainio Foundation; Freiburg University Hospital, Center for Clinical Research (Project C3, ZKF II); and Centre de Recherche et d'Information Nutritionnelles de Paris, France. Dr. Bouchard is partially funded by the George A. Bray Chair in Nutrition.

Potential Financial Conflicts of Interest:Employment: C. Bouchard (Louisiana State University, Pennington Biomedical Research Center); Consultancies: C. Bouchard (Almond Board of California, Baylor Children's Nutrition and Research Center, Boston Obesity and Nutrition Research Center, Bristol-Myers Squibb, Institutes for Pharmaceutical Discovery, Mars, Inc., Pennington Management of Clinical Trials, Sanofi-Synthelabo, Cooper Institute for Aerobic Research, Weight Watchers International); Honoraria: C. Bouchard; Grants received: C. Bouchard (Bristol-Myers Squibb).

Requests for Single Reprints: Dr. Rauramaa: Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FIN-70100 Kuopio, Finland; e-mail, rainer.rauramaa{at}uku.fi.

Current Author Addresses: Drs. Rauramaa, Väisänen, and Penttilä: Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FIN-70100 Kuopio, Finland.

Ms. Halonen: IT Service Centre, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland.

Drs. Lakka, Rankinen, and Bouchard: Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808-4124.

Drs. Schmidt-Trucksäss and Berg: Department of Rehabilitative and Preventative Sports Medicine, University of Freiburg, Hugstetterstrasse 55, D-79106 Freiburg, Germany.

Author Contributions: Conception and design: R. Rauramaa, S.B. Väisänen, A. Berg, T. Rankinen, C. Bouchard.

Analysis and interpretation of the data: R. Rauramaa, P. Halonen, S.B. Väisänen, T.A. Lakka, A. Schmidt-Trucksäss, I.M. Penttilä, T. Rankinen.

Drafting of the article: R. Rauramaa, S.B. Väisänen, T.A. Lakka.

Critical revision of the article for important intellectual content: R. Rauramaa, P. Halonen, S.B. Väisänen, T.A. Lakka, A. Schmidt-Trucksäss, A. Berg, I.M. Penttilä, T. Rankinen, C. Bouchard.

Final approval of the article: R. Rauramaa, P. Halonen, S.B. Väisänen, T.A. Lakka, A. Schmidt-Trucksäss, A. Berg, I.M. Penttilä, C. Bouchard.

Provision of study materials or patients: R. Rauramaa, A. Schmidt-Trucksäss.

Statistical expertise: P. Halonen.

Obtaining of funding: R. Rauramaa, A. Berg, I.M. Penttilä.

Administrative, technical, or logistic support: R. Rauramaa, S.B. Väisänen, I.M. Penttilä.

Collection and assembly of data: R. Rauramaa, T. Rankinen.

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