Advertisement
Mayo Clinic Proceedings Home
MCP Digital Health Home

Physical Activity, Inflammation, Coronary Artery Calcification, and Incident Coronary Heart Disease in African Americans: Insights From the Jackson Heart Study

      Abstract

      Objective

      To examine associations between physical activity (PA), inflammation, coronary artery calcification (CAC), and incident coronary heart disease (CHD) in African Americans.

      Methods

      Among Jackson Heart Study participants without prevalent CHD at baseline (n=4295), we examined the relationships between PA and high-sensitivity C-reactive protein, the presence of CAC (Agatston score ≥100), and incident CHD. Based on the American Heart Association’s Life’s Simple 7 metrics, participants were classified as having poor, intermediate, or ideal PA.

      Results

      After adjustment for possible confounding factors, ideal PA was associated with lower high-sensitivity C-reactive protein levels (β, −0.15; 95% CI, −0.15 to −0.002) and a lower prevalence of CAC (odds ratio, 0.70; 95% CI, 0.51-0.96) compared with poor PA. During a median of 12.8 years of follow-up, there were 164 incident CHD events (3.3/1000 person-years). Ideal PA was associated with a lower rate of incident CHD compared with poor PA (hazard ratio, 0.55; 95% CI, 0.31-0.98).

      Conclusion

      In a large community-based African American cohort, ideal PA was associated with lower inflammation levels, a lower prevalence of CAC, and a lower rate of incident CHD. These findings suggest that promotion of ideal PA may be an important way to reduce the risk of subclinical and future clinical CHD in African Americans.

      Abbreviations and Acronyms:

      AHA (American Heart Association), BMI (body mass index), CAC (coronary artery calcification), CHD (coronary heart disease), CV (cardiovascular), hs-CRP (high-sensitivity C-reactive protein), JHS (Jackson Heart Study), PA (physical activity)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Shiroma E.J.
        • Lee I.M.
        Physical activity and cardiovascular health: lessons learned from epidemiological studies across age, gender, and race/ethnicity.
        Circulation. 2010; 122: 743-752
        • Manson J.E.
        • Greenland P.
        • LaCroix A.Z.
        • et al.
        Walking compared with vigorous exercise for the prevention of cardiovascular events in women.
        N Engl J Med. 2002; 347: 716-725
        • Folsom A.R.
        • Arnett D.K.
        • Hutchinson R.G.
        • Liao F.
        • Clegg L.X.
        • Cooper L.S.
        Physical activity and incidence of coronary heart disease in middle-aged women and men.
        Med Sci Sports Exerc. 1997; 29: 901-909
        • Bell E.J.
        • Lutsey P.L.
        • Windham B.G.
        • Folsom A.R.
        Physical activity and cardiovascular disease in African Americans in Atherosclerosis Risk in Communities.
        Med Sci Sports Exerc. 2013; 45: 901-907
        • Dubbert P.M.
        • Robinson J.C.
        • Sung J.H.
        • et al.
        Physical activity and obesity in African Americans: the Jackson Heart Study.
        Ethn Dis. 2010; 20: 383-389
        • Imran T.F.
        • Patel Y.
        • Ellison R.C.
        • et al.
        Walking and calcified atherosclerotic plaque in the coronary arteries: the National Heart, Lung, and Blood Institute Family Heart Study.
        Arterioscler Thromb Vasc Biol. 2016; 36: 1272-1277
        • Parsons T.J.
        • Sartini C.
        • Ellins E.A.
        • et al.
        Objectively measured physical activity and sedentary behaviour and ankle brachial index: cross-sectional and longitudinal associations in older men.
        Atherosclerosis. 2016; 247: 28-34
        • Kozakova M.
        • Palombo C.
        • Mhamdi L.
        • et al.
        Habitual physical activity and vascular aging in a young to middle-age population at low cardiovascular risk.
        Stroke. 2007; 38: 2549-2555
        • Pahkala K.
        • Heinonen O.J.
        • Simell O.
        • et al.
        Association of physical activity with vascular endothelial function and intima-media thickness.
        Circulation. 2011; 124: 1956-1963
        • Blaha M.J.
        • Whelton S.P.
        • Al Rifai M.
        • et al.
        Comparing risk scores in the prediction of coronary and cardiovascular deaths: Coronary Artery Calcium Consortium.
        JACC Cardiovasc Imaging. 2020 Jan 9; (S1936-878X(19)31180-5. [Online ahead of print])
        • Zheng Z.J.
        • Sharrett A.R.
        • Chambless L.E.
        • et al.
        Associations of ankle-brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) study.
        Atherosclerosis. 1997; 131: 115-125
        • Polak J.F.
        • Szklo M.
        • O'Leary D.H.
        Carotid intima-media thickness score, positive coronary artery calcium score, and incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis.
        J Am Heart Assoc. 2017; 6: e004612
        • Wolf D.
        • Ley K.
        Immunity and inflammation in atherosclerosis.
        Circ Res. 2019; 124: 315-327
        • Hammonds T.L.
        • Gathright E.C.
        • Goldstein C.M.
        • Penn M.S.
        • Hughes J.W.
        Effects of exercise on C-reactive protein in healthy patients and in patients with heart disease: a meta-analysis.
        Heart Lung. 2016; 45: 273-282
        • Djousse L.
        • Petrone A.B.
        • Blackshear C.
        • et al.
        Prevalence and changes over time of ideal cardiovascular health metrics among African-Americans: the Jackson Heart Study.
        Prev Med. 2015; 74: 111-116
        • Taylor Jr., H.A.
        The Jackson Heart Study: an overview.
        Ethn Dis. 2005; 15 (S6-1-3)
        • Fox E.R.
        • Musani S.K.
        • Bidulescu A.
        • et al.
        Relation of obesity to circulating B-type natriuretic peptide concentrations in blacks: the Jackson Heart Study.
        Circulation. 2011; 124: 1021-1027
        • Koo P.
        • Gjelsvik A.
        • Choudhary G.
        • et al.
        Prospective association of physical activity and heart failure hospitalizations among black adults with normal ejection fraction: the Jackson Heart Study.
        J Am Heart Assoc. 2017; 6: e006107
        • Keku E.
        • Rosamond W.
        • Taylor Jr., H.A.
        • et al.
        Cardiovascular disease event classification in the Jackson Heart Study: methods and procedures.
        Ethn Dis. 2005; 15 (S6-62-70)
        • Carpenter M.A.
        • Crow R.
        • Steffes M.
        • et al.
        Laboratory, reading center, and coordinating center data management methods in the Jackson Heart Study.
        Am J Med Sci. 2004; 328: 131-144
        • Fox E.R.
        • Benjamin E.J.
        • Sarpong D.F.
        • et al.
        Epidemiology, heritability, and genetic linkage of C-reactive protein in African Americans (from the Jackson Heart Study).
        Am J Cardiol. 2008; 102: 835-841
        • Liu J.
        • Musani S.K.
        • Bidulescu A.
        • et al.
        Fatty liver, abdominal adipose tissue and atherosclerotic calcification in African Americans: the Jackson Heart Study.
        Atherosclerosis. 2012; 224: 521-525
        • Fox E.R.
        • Samdarshi T.E.
        • Musani S.K.
        • et al.
        Development and validation of risk prediction models for cardiovascular events in black adults: the Jackson Heart Study Cohort.
        JAMA Cardiol. 2016; 1: 15-25
        • Criqui M.H.
        • Denenberg J.O.
        • Ix J.H.
        • et al.
        Calcium density of coronary artery plaque and risk of incident cardiovascular events.
        JAMA. 2014; 311: 271-278
        • Gregg E.W.
        • Gerzoff R.B.
        • Caspersen C.J.
        • Williamson D.F.
        • Narayan K.M.
        Relationship of walking to mortality among US adults with diabetes.
        Arch Intern Med. 2003; 163: 1440-1447
        • Florido R.
        • Kwak L.
        • Lazo M.
        • et al.
        Physical activity and incident heart failure in high-risk subgroups: the ARIC study.
        J Am Heart Assoc. 2020; 9: e014885
        • Hamer M.
        • Venuraju S.M.
        • Lahiri A.
        • Rossi A.
        • Steptoe A.
        Objectively assessed physical activity, sedentary time, and coronary artery calcification in healthy older adults.
        Arterioscler Thromb Vasc Biol. 2012; 32: 500-505
        • Mozaffarian D.
        • Benjamin E.J.
        • Go A.S.
        • et al.
        • Writing Group Members
        American Heart Association Statistics Committee; Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics—2016 update: a report from the American Heart Association [erratum in Circulation. 2016;133(15):e599].
        Circulation. 2016; 133: e38-e360
        • Wali R.K.
        • Weir M.R.
        Hypertensive cardiovascular disease in African Americans.
        Curr Hypertens Rep. 1999; 1: 521-528
        • Rosamond W.D.
        • Folsom A.R.
        • Chambless L.E.
        • et al.
        Stroke incidence and survival among middle-aged adults: 9-year follow-up of the Atherosclerosis Risk in Communities (ARIC) cohort.
        Stroke. 1999; 30: 736-743

      Linked Article