Physical Activity, Inflammation, Coronary Artery Calcification, and Incident Coronary Heart Disease in African Americans: Insights From the Jackson Heart Study

Abstract

Objective: To examine associations between physical activity, inflammation, coronary artery calcification and incident coronary heart disease in African Americans. Methods: Among Jackson Heart Study participants without prevalent coronary heart disease at baseline (n=4295), we examined the relationships between physical activity and high-sensitivity CRP, the presence of coronary artery calcification (Agatston score≥100), and incident coronary heart disease. Based on the American Heart Association’s Life’s Simple 7 metrics, participants were classified as having poor, intermediate or ideal physical activity. Results: After adjusting for possible confounding factors, ideal physical activity was associated with lower high-sensitivity CRP levels (β: −0.15, 95%CI −0.15, −0.002) and a lower prevalence of coronary artery calcification (odds ratio: 0.70, 95%CI 0.51, 0.96) compared with poor physical activity. Over a median of 12.8 years follow up, there were 164 incident coronary heart disease events (3.3/1000 person-years). Ideal physical activity was associated with a lower rate of incident coronary heart disease compared with poor physical activity (hazard ratio 0.55, 95% CI 0.31, 0.98). Conclusions: In a large community-based African American cohort, ideal physical activity was associated with lower inflammation levels, a lower prevalence of coronary artery calcification, and a lower rate of incident coronary heart disease. These findings suggest that promotion of ideal physical activity may be an important way to reduce the risk of subclinical and future clinical coronary heart disease in African Americans.