Study Finds No Association Between Physical Activity, Coronary Artery Calcium Progression


In prior studies, higher levels of physical activity were associated with higher prevalence of coronary artery calcium.

Physical activity has not been associated with progression of coronary artery calcium in healthy women and men who initially did not have cardiovascular disease (CVD), according to a study published in JAMA Cardiology. In prior studies, the study authors said that high levels of physical activity have been associated with higher prevalence of coronary artery calcium.1

Running at sunrise couple exercising for marathon and workout | Image Credit: bunyarit -

Image Credit: bunyarit -

In 2017, a study by Mayo Clinic Proceedings showed that physical activity for men may not reduce the risk of coronary artery calcification, and found that highly active White men are approximately 86% more likely to have a build-up of plaque in their arteries compared with less active individuals. Further, the investigators found that patients who exercised the most were approximately 27% more likely to develop coronary artery calcium compared to individuals who exercised the least.2

In the current study, the authors stated that physical activity reduces the risk of premature death from all causes, CVD, and cancer, and lowers the risk of chronic illness. However, there has been evidence that has shown that some physically active individuals could also experience CVD events or sudden cardiac death. Therefore, the authors of the study aimed to test whether the rate of progression of mean coronary artery calcium could be associated with physical activity over multiple time points and whether the baseline level of physical activity could be associated with coronary artery calcium progression in a clinically meaningful way.1

Investigators included individuals who were community-dwelling adults aged 40 and older, had 2 or more clinic visits between 1998 and 2019, and had completed data on the primary study variables. Personal history of myocardial infarction, stroke, cardiac stent, coronary artery bypass surgery, and body mess index of less than 18.5 were excluded from the study.1

Investigators gathered information on leisure time physical activity, including weekly frequency and mean duration of aerobic activities, during a 3-month period. Moderate and vigorous activity was calculated with the activity’s intensity and total minutes per week, according to the study authors.1

There were 8771 individuals included in the study with mean baseline ages of 50.2 years for men and 51.1 years for women. Mean physical activity was 1247 metabolic equivalents (MET)-min/wk at baseline and 1206 MET-min/wk, respectively, compared with 1406 MET-min/wk and 1283 MET-min/wk at the last follow-up, respectively. Furthermore, the study authors reported that statin use increased from baseline to last follow up from 17% to 39% and was generally comparable across categories of physical activity intensity.1

Key Takeaways

  1. Previous studies suggested high physical activity might be linked to increased coronary artery calcium (CAC) levels.
  2. This new study found no association between physical activity levels and CAC progression in healthy adults without existing cardiovascular disease (CVD).
  3. Overall, physical activity remains recommended for its well-established benefits in reducing the risk of chronic diseases and premature death.

Investigators found that there were higher levels of baseline coronary artery calcium associated with larger coronary artery calcium changes and rates of change for both men and women, according to the results. However, the authors added that this was not generally associated with higher levels of baseline physical activity. Further, higher levels of baseline physical activity with coronary artery calcium categories were not associated with all cause of CVD mortality.1

The rate of mean coronary artery calcium progression per year from baseline was approximately 28.5% in men and 32.1% in women, independent of physical activity for the same time period. The differences of coronary artery calcium progression per year was 0.0% per 500 MET-min/wk, according to the study authors. Generally, levels of physical activity of 0, 1500, or 3000 MET-min/wk had equal relative rates of coronary artery calcium progression, according to the study authors.1

  1. Shuval K, Leonard D, DeFina LF, et al. Physical Activity and Progression of Coronary Artery Calcification in Men and Women. JAMA Cardiol. Published online May 15, 2024. doi:10.1001/jamacardio.2024.0759
  2. Toich L. Physical Activity May Not Reduce Coronary Artery Calcification Risk. Pharmacy Times. October 31, 2017. Accessed May 21, 2024.
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