Abstract 12239: Objectively Measured Physical Activity Decreases the Risk of Subclinical Cardiovascular Disease: A Systematic Review

Abstract

Introduction: Physical activity (PA) decreases the risk of cardiovascular events, but to what degree this is related to effects on surrogate markers of subclinical cardiovascular disease (CVD) is unclear. Clarifying the relationship between objectively measured PA and subclinical CVD would provide justification for using measures of subclinical CVD in clinical trials of PA interventions. Hypothesis: We hypothesized that higher levels of objectively measured PA are associated with less subclinical CVD. Methods: We performed a systematic review using Medline, Embase, CINAHL and Cochrane (January 1, 2000 - January 12, 2022). Studies of adult populations that examined the relationship between objectively measured PA (accelerometry) and subclinical CVD were included. Markers for subclinical CVD included: ankle brachial index ( n =4 studies); arterial stiffness ( n =31); carotid artery plaque/stenosis and intima media thickness ( n =9); coronary artery atherosclerosis ( n =4); endothelial function ( n =8); measures of cardiac structure and function ( n =4); and eight studies included multiple of the aforementioned outcomes. For those studies, we considered results on each outcome separately. Risk of bias was also assessed. Results: PA was inversely associated with subclinical CVD in 60 of 78 included analyses (76.9%). Of these, five studies (6.4%) found only an association with higher levels of PA. In six studies (7.7%), PA was no longer associated with subclinical CVD after adjustment for confounders. Seven analyses (9.0%) demonstrated mixed results but demonstrated an inverse relationship between PA and subclinical CVD in specific circumstances. Only 18 studies (23.1%) suggested that PA was not associated with decreased subclinical CVD. Conclusions: Increased PA is associated with less subclinical CVD across diverse populations. Interventions to increase PA have the potential to reduce the burden of subclinical CVD and, therefore, clinical CVD events.