The Multi-Ethnic Study of Atherosclerosis examined the relationship between physical activity and subclinical atherosclerosis [ankle-brachial index (ABI), coronary artery calcification and internal and common carotid intima-media thickness (IMT)] in a sample of 6,482 men and women aged 45-84 years without prior clinical cardiovascular disease. After taking into account confounders (age, race/ethnicity, clinic site, education, income and smoking), increasing total, moderate + vigorous and intentional-exercise physical activity was not associated with IMT or coronary artery calcification. In women, a relationship was observed with ABI. Moreover, walking pace was favourably associated with common carotid IMT, ABI and coronary artery calcification in men and with common carotid IMT and ABI in women. Further adjustments for lipid variables, hypertension, diabetes and body mass index attenuated these relationships that, in some cases, became nonsignificant. These results suggest that the relationship between physical activity and subclinical atherosclerosis may be partly mediated through changes in cardiovascular disease risk factors.
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