Effect of regular physical activity on carotid intima-media thickness. Results from a 6-year prospective study in the early stage of hypertension

Aim. To study the effect of leisure-time physical activity on the progression of carotid intima-media thickness (IMT) in the early stage of hypertension. Methods. We studied 47 sedentary and 40 physically active young pre-hypertensive or stage 1 hypertensive subjects. IMT was assessed in the common carotid artery, carotid bulb and internal carotid artery at baseline and after 6.5 years. Results. Cumulative maximum IMT of the three carotid segments (M-MAX, 0.13 +/- 0.08 vs 0.10 +/- 0.07 mm, p = 0.006) and cumulative mean IMT (m-IMT, 0.11 +/- 0.07 vs 0.09 +/- 0.06 mm, p = 0.01), adjusted for con-founders, increased to a greater degree in the sedentary than the active subjects. Differences in known risk factors explained a large proportion of the observed association. Inclusion of baseline cholesterol in the regression model attenuated the strength of the association for both M-MAX (p - 0.04) and m-IMT (p - 0.049). When also baseline blood pressure, heart rate, and body mass index were taken into account the association with physical activity status remained significant for maximum IMT of internal carotid artery (p = 0.034) and was of borderline significance for M-MAX (p = 0.066). Conclusions. Physical activity can delay the progression of carotid IMT in hypertension. This effect is mediated in substantial part by the better risk factor profile in active subjects.