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

A Six-Year Randomized, Controlled Trial

  1. Rainer Rauramaa, MD, PhD;
  2. Pirjo Halonen, MSc;
  3. Sari B. Väisänen, PhD;
  4. Timo A. Lakka, MD, PhD;
  5. Arno Schmidt-Trucksäss, MD, PhD;
  6. Aloys Berg, MD, PhD;
  7. Ilkka M. Penttilä, MD, PhD;
  8. Tuomo Rankinen, PhD; and
  9. Claude Bouchard, PhD
  1. From Kuopio Research Institute of Exercise Medicine, University of Kuopio, and Kuopio University Hospital, Kuopio, Finland; University of Freiburg, Freiburg, Germany; and Louisiana State University, Baton Rouge, Louisiana.

    Abstract

    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.

    Article and Author Information

    • Grant Support: By the Ministry of Education in Finland (322/722/94, 80/722/95, 176/722/96, 42/722/97, 84/722/98, 138/722/99, 112/722/2000); Academy of Finland (68103/1999, 72401/2000); City of Kuopio; Finnish Heart Association; Juho Vainio Foundation; Freiburg University Hospital, Center for Clinical Research (Project C3, ZKF II); and Centre de Recherche et d'Information Nutritionnelles de Paris, France. Dr. Bouchard is partially funded by the George A. Bray Chair in Nutrition.

    • Potential Financial Conflicts of Interest:Employment: C. Bouchard (Louisiana State University, Pennington Biomedical Research Center); Consultancies: C. Bouchard (Almond Board of California, Baylor Children's Nutrition and Research Center, Boston Obesity and Nutrition Research Center, Bristol-Myers Squibb, Institutes for Pharmaceutical Discovery, Mars, Inc., Pennington Management of Clinical Trials, Sanofi-Synthelabo, Cooper Institute for Aerobic Research, Weight Watchers International); Honoraria: C. Bouchard; Grants received: C. Bouchard (Bristol-Myers Squibb).

    • Requests for Single Reprints: Dr. Rauramaa: Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FIN-70100 Kuopio, Finland; e-mail, rainer.rauramaa{at}uku.fi.

    • Current Author Addresses: Drs. Rauramaa, Väisänen, and Penttilä: Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FIN-70100 Kuopio, Finland.

    • Ms. Halonen: IT Service Centre, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland.

    • Drs. Lakka, Rankinen, and Bouchard: Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA 70808-4124.

    • Drs. Schmidt-Trucksäss and Berg: Department of Rehabilitative and Preventative Sports Medicine, University of Freiburg, Hugstetterstrasse 55, D-79106 Freiburg, Germany.

    • Author Contributions: Conception and design: R. Rauramaa, S.B. Väisänen, A. Berg, T. Rankinen, C. Bouchard.

    • Analysis and interpretation of the data: R. Rauramaa, P. Halonen, S.B. Väisänen, T.A. Lakka, A. Schmidt-Trucksäss, I.M. Penttilä, T. Rankinen.

    • Drafting of the article: R. Rauramaa, S.B. Väisänen, T.A. Lakka.

    • Critical revision of the article for important intellectual content: R. Rauramaa, P. Halonen, S.B. Väisänen, T.A. Lakka, A. Schmidt-Trucksäss, A. Berg, I.M. Penttilä, T. Rankinen, C. Bouchard.

    • Final approval of the article: R. Rauramaa, P. Halonen, S.B. Väisänen, T.A. Lakka, A. Schmidt-Trucksäss, A. Berg, I.M. Penttilä, C. Bouchard.

    • Provision of study materials or patients: R. Rauramaa, A. Schmidt-Trucksäss.

    • Statistical expertise: P. Halonen.

    • Obtaining of funding: R. Rauramaa, A. Berg, I.M. Penttilä.

    • Administrative, technical, or logistic support: R. Rauramaa, S.B. Väisänen, I.M. Penttilä.

    • Collection and assembly of data: R. Rauramaa, T. Rankinen.

    Responses to this article

    • Effects of aerobic physical exercise and atherosclerosis in men
      • Th. F.M. Fennis and
      • J. W. Vredeveld
      Ann Intern Med published online October 26, 2009
    • Misleading Conclusions
      • Vernon C Jones
      Ann Intern Med published online October 26, 2009

    Summary for Patients

    • Summaries for Patients:Does Aerobic Exercise Slow Progression of Atherosclerosis? Ann Intern Med June 15, 2004 140:I-37
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    1. Ann Intern Med June 15, 2004 vol. 140 no. 12 1007-1014
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