Abstract P136: The Effect of Exercise Training on 10-Year Atherosclerotic Cardiovascular Disease Risk in Individuals with Type 2 Diabetes

Abstract

Introduction: The American Heart Association (AHA) pooled cohort equations provide sex and race specific estimates of 10-year atherosclerotic cardiovascular disease (ASCVD) risk based on traditional risk factors, but not physical activity (PA) or fitness. The effect of exercise training on estimated ASCVD risk has not been previously evaluated, which is clinically relevant to individuals with type 2 diabetes (T2D) who have increased risk of ASCVD. The purpose of the present study is to determine the effect of aerobic (AER), resistance (RES) or combination (COMB) exercise training on 10-year ASCVD risk in individuals with T2D. Methods: The present study is an ancillary analysis of the Health Benefits of Aerobic and Resistance Training Study (HART-D). Adults with T2D (n=148) were randomized to 9 months of AER, RES, COMB exercise training or a control group (CON); 10-year ASCVD risk was calculated using the AHA pooled cohort equations based on each participants’ demographic (age, sex, race) and clinical data (high density lipoprotein, total cholesterol, systolic blood pressure/history of hypertension) and known T2D status at baseline and follow-up. Change in ASCVD risk was evaluated with an analysis of covariance with adjustment for baseline ASCVD risk. Results: Participants in the present analysis had a mean (SD) 10-year ASCVD risk of 12.2% (9.4). Baseline ASCVD risk was associated with body fat (r=-0.22, p< 0.001) and duration of T2D (r=0.18, p=0.03), but not with peak VO 2 , hemoglobin A 1C , or other cardiometabolic variables (p>0.05). No significant change in ASCVD risk was observed in the AERO (-0.36%, CI: -1.44 to 0.71), RES (-0.43%, CI: -1.49 to 0.63) and the COMB groups (-0.54%, CI: -1.57 to 0.49) compared to the CON (0.02%, CI: -1.26 to 1.31) group. However, in exercisers only, the change in diastolic blood pressure was associated with change in ASCVD (r=0.34, p<0.001), but not change in hemoglobin A 1C , peak VO 2 , body fat mass, or other cardiometabolic risk factors (p>0.05). Conclusions: The present study suggests that 9 months of exercise training did not reduce ASCVD risk predicted by the pooled cohort equations. Since exercise training is recommended by the AHA to reduce ASCVD risk especially in adults with T2D, future studies should evaluate if adding a variable that represents physical activity and/or fitness provides additional discrimination in the prediction of ASCVD.