Effects of Aerobic Physical Exercise on Inflammation and Atherosclerosis in Men: The DNASCO Study

Background: Although regular physical activity is recommended for prevention of cardiovascular diseases, no data are available on its antiatherosclerotic effects in the general population. Objective: To determine whether progressive aerobic exercise compared with usual activity slows progression of atherosclerosis in men. Design: A 6-year randomized, controlled trial. Setting: Eastern Finland. Participants: 140 middle-aged men randomly selected from the population registry. Intervention: Low- to moderate-intensity aerobic exercise. Measurements: Atherosclerosis was quantitated ultrasonographically as the mean intima–media thickness in the carotid artery at baseline and at years 2 through 6. Results: On the basis of intention-to-treat analyses, a 19.5% net increase (P < 0.001) in ventilatory aerobic threshold was evident in the exercise group after 6 years. High-sensitivity C-reactive protein levels were statistically nonsignificantly lower in the exercise group than in the control group (P > 0.2). The progression of intima–media thickness in the carotid artery did not differ between the study groups (P > 0.2). A subgroup analysis that excluded men taking statins showed that the 6-year progression of intima–media thickness, adjusted for smoking and annual measures of low-density lipoprotein cholesterol level, systolic blood pressure, and waist circumference, was 40% less in the exercise group (0.12 mm [95% CI, −0.010 to 0.26 mm]) than in the control group (0.20 mm [CI, 0.05 to 0.35 mm]). Limitations: Only middle-aged white men were included. The intervention included mainly aerobic exercises. Conclusions: Aerobic physical exercise did not attenuate progression of atherosclerosis, except in a subgroup of men not taking statins.