A US prospective observational study showed that high levels of physical activity are associated with prevalent coronary artery calcification (CAC) but are not associated with increased all-cause or cardiovascular disease (CVD) mortality after a decade of follow-up, even in the presence of clinically significant CAC levels. The study included 21 758 male participants (baseline mean age 51.7 years), from January 13, 1998, through December 30, 2013, with mortality follow-up through December 31, 2014. Men with ≥3000 metabolic equivalent of task (MET)-min/wk were more likely to have prevalent CAC of ≥100 Agatston units (AU, relative risk, 1.11) compared with those accumulating less physical activity. In the group with physical activity of ≥3000 MET-min/wk and CAC of ≥100 AU, mean CAC level was 807 AU. After a mean follow-up of 10.4 years, 759 all-cause and 180 CVD deaths occurred, including 40 all-cause and 10 CVD deaths among those with physical activity of ≥3000 MET-min/wk. Men with CAC of <100 AU and physical activity of ≥3000 MET-min/wk were about half as likely to die compared with men with <1500 MET-min/wk (hazard ratio [HR], 0.52). In the group with CAC of ≥100 AU, men with ≥3000 MET-min/wk did not have a significant increase in all-cause mortality (HR, 0.77) when compared with men with physical activity of <1500 MET-min/wk. In the least active men, those with CAC of ≥100 AU were twice as likely to die of CVD compared with those with CAC of <100 AU (HR, 1.93). The results do not support the contention that high-volume endurance activity, with a mean of more than 1 hour of activity per day, increases the risk of all-cause or CVD mortality, regardless of CAC level. The health benefits of regular physical activity are well known. Source: https://jamanetwork.com/
