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BMJ Open 4:e004498 doi:10.1136/bmjopen-2013-004498
  • Cardiovascular medicine
    • Research

Influence of chronic exercise on carotid atherosclerosis in marathon runners

  1. Paul D Thompson1
  1. 1Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
  2. 2Department of Health Sciences, University of Hartford, Bloomfield, Connecticut, USA
  3. 3Children's Hospital, Boston, Massachusetts, USA
  4. 4Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Beth A Taylor; beth.taylor{at}hhchealth.org
  • Received 18 November 2013
  • Revised 10 January 2014
  • Accepted 17 January 2014
  • Published 14 February 2014

Abstract

Objectives The effect of habitual, high-intensity exercise training on the progression of atherosclerosis is unclear. We assessed indices of vascular health (central systolic blood pressure (SBP) and arterial stiffness as well as carotid intima-medial thickness (cIMT)) in addition to cardiovascular risk factors of trained runners versus their untrained spouses or partners to evaluate the impact of exercise on the development of carotid atherosclerosis.

Setting field study at Boston Marathon.

Participants 42 qualifiers (mean age±SD: 46±13 years, 21 women) for the 2012 Boston Marathon and their sedentary domestic controls (46±12 years, n=21 women).

Outcomes We measured medical and running history, vital signs, anthropometrics, blood lipids, C reactive protein (CRP), 10 years Framingham risk, central arterial stiffness and SBP and cIMT.

Results Multiple cardiovascular risk factors, including CRP, non-high-density lipoprotein cholesterol, triglycerides, heart rate, body weight and body mass index (all p<0.05), were reduced in the runners. The left and right cIMT, as well as central SBP, were not different between the two groups (all p>0.31) and were associated with age (all r≥0.41; p<0.01) and Framingham risk score (all r≥0.44; p<0.01) independent of exercise group (all p>0.08 for interactions). The amplification of the central pressure waveform (augmentation pressure at heart rate 75 bpm) was also not different between the two groups (p=0.07) but was related to age (p<0.01) and group (p=0.02) in a multiple linear regression model.

Conclusions Habitual endurance exercise improves the cardiovascular risk profile, but does not reduce the magnitude of carotid atherosclerosis associated with age and cardiovascular risk factors.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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