REPLY
Exercise and Atherosclerosis
The Editors
7 December 2004 | Volume 141 Issue 11 | Page 890
IN RESPONSE:
The randomized, controlled trial conducted by Rauramaa and colleagues compared 6-year progression of carotid intimamedia thickness between men assigned to usual activity and men assigned to a progressive aerobic exercise program. The modest-sized trial involved 140 middle-aged Finnish men randomly selected from a population registry; of these, 14% had incomplete follow-up data. Intention-to-treat analyses showed no clinically important or statistically significant differences in intimamedia thickness progression between groups. A secondary analysis that excluded the few patients who were taking statins found a statistically significant difference in progression (P = 0.02). At 6 years, the average increase in intimamedia thickness in the exercise group was 40% lower (absolute difference of 0.08 mm) than that in the control group. Strictly speaking, the correct conclusion that matches the study's original design and intention-to-treat analysis is what was reflected in the abstract and the Editors' Notes: Aerobic exercise did not attenuate or slow progression of atherosclerosis in the overall group of middle-aged men enrolled in the study. The subgroup findings suggested that exercise prevented atherosclerotic progression in some middle-aged menthose not taking statins. No formal analyses addressed whether exercise did or did not prevent progression in the small sample of men taking statins (n = 15); statistical power to address effects in this subgroup was low. As stated in the last paragraph of the paper, these findings support the concept that regular aerobic exercise probably helps prevent atherosclerotic disease in some men.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.