Lifestyle

Physical activity can paradoxically accelerate the accumulation of risk factors for heart attack

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Physical activity can paradoxically accelerate the accumulation of coronary calcium deposits (plaques), the amount of which is used to assess the risk of future cardiovascular disease, published online in the journal. Find a study heart..

However, the findings do not outweigh the many health benefits of exercise, researchers emphasize.

The coronary calcium score, or CAC score for short, is used to guide treatment to prevent a heart attack or stroke. Statins are indicated for most people with a CAC score of 100 or higher.

Regular physical activity is associated with a dose-dependent reduction in the risk of obesity, diabetes, heart attack / stroke, and death, among others.

However, studies show that despite these important health benefits, people who are very physically active appear to have high levels of calcium deposits in the coronary arteries. artery.. Therefore, it is not clear whether exercise itself may be associated with calcification (arteriosclerosis).

To further investigate this, researchers regularly conducted at two major health centers in Suwon, Seoul and South Korea between March 2011 and December 2017 as part of the Kambuk Samsung Health Survey. We surveyed healthy adults who underwent a comprehensive examination.

At each health check, participants completed a questionnaire containing questions about their medical and family history, lifestyle and educational background. Body weight (BMI), blood pressure, And triglycerides were also evaluated.

Physical activity was formally classified as either inactive, moderately active, or “health-promoting” (very) physically active on the first test using a validated questionnaire. ..

The scan tracked the development and / or progression of coronary artery calcification and was subsequently scored (CAC score) for an average of 3 years.

The final analysis included approximately 25,485 people (22,741 men and 2,744 women) with a CAC score of 2 or more over the age of 30.

About 47% (11,920), 38% (9683), and 15% (3882) of them were inactive, moderately active, and intensely physically active, respectively. This is equivalent to running 6.5 km / day.

Physically active people tended to be older and less likely to smoke than physically weak people Active participants..They also have lower and more total cholesterol High blood pressure, And existing evidence of calcification in the coronary arteries.

Gradual association between Physical activity level The prevalence and progression of coronary artery calcification appeared over time, regardless of the CAC score at the beginning of the monitoring period.

Estimated adjusted mean CAC scores for all three groups at the start of the monitoring period were 9.45, 10.20, and 12.04, respectively.

However, higher physical activity was associated with faster progression of CAC scores in both those without calcification and those who already had a CAC score at the beginning of the monitoring period.

Estimated adjusted 5-year average increase in CAC score for moderately and highly active participants compared to inactive individuals, which contributes to potentially influential factors such as BMI, blood pressure, and triglyceride. Even after consideration, it was 3.20 and 8.16, respectively.

Since this is an observational study, the cause cannot be determined. Researchers also acknowledge the limitations of some studies, including the lack of an objective assessment of physical activity. There are no data on the density or amount of accidental heart attack / stroke or CAC.

They say that physical activity can increase coronary atherosclerosis (arterial stenosis) through the physiological responses it promotes, such as mechanical stress, damage to the walls of blood vessels, and increased blood pressure and parathyroid hormones. Explains. They also suggest that physical activity may alter the effects of diet, vitamins and minerals.

“The second possibility is that it can increase the CAC score without increasing physical activity. [cardiovascular disease] “Risk” is written.

“There is no doubt about the cardiovascular benefits of physical activity,” they emphasize, recommending at least 150-300 minutes / week of moderate intensity or 75-150 minutes / week of intense aerobic exercise. Repeating national guidelines.

“But patients and physicians need to consider that engaging in physical activity can accelerate the progression of coronary calcium, probably due to plaque healing, stabilization, and calcification.” They conclude.

In a linked editorial, Dr. Gaurav Gulsin and Alastair James Moss of the University of Leicester Cardiovascular Sciences said, “These findings mean that the use of coronary calcium scores should be discontinued to assess coronary artery disease. mosquito?”

This study highlights the complexity of interpreting a patient’s CAC score. Physical activity Or started taking statins — they point out that this is also associated with higher scores.

“Proponents would argue that it is an effective tool for screening asymptomatic atherosclerosis in asymptomatic individuals, but clinicians say this in otherwise healthy individuals. You need to be careful about the abuse of the test, “they warn.

In a linked podcast, Dr. Moss scores to assess future risk of heart attack or stroke, as non-calcified plaques, which are more unstable and more likely to rupture, may be more important. Explains that it is necessary.

“It’s possible that we’re looking for non-calcified plaques, not calcified plaques,” he suggests. This did not appear in the scan used in this study.

“Increase rate Coronary arteries Calcification is a phenomenon observed in response to both effective treatments such as statin therapy and exercise.However, continuous imaging with calcium scans should not necessarily be considered the best way to evaluate accurately. [cardiovascular disease] The risks of these individuals.

But he repeats. “Clearly, exercise is one of the best ways to try to control cardiovascular risk. [people without symptoms].. ”


Over 40% of adults with no known heart disease had fat deposits in the heart arteries


Quote: Physical activity, paradoxically, is a risk factor for heart attack obtained from https://medicalxpress.com/news/2021-09-physical-paradoxically-hasten-build-up-heart on September 20, 2021. (2021, September 20th) may accelerate the accumulation.html

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Physical activity can paradoxically accelerate the accumulation of risk factors for heart attack

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