Physical Activity May Reduce CVD Risk in Older Postmenopausal Women

Laurie Barclay, MD

November 15, 2010

November 15, 2010 — Physical activity in older, but not younger, postmenopausal women is associated with lower coronary artery calcification (CAC), according to the results of a study reported in the November/December issue of Menopause: The Journal of the North American Menopause Society.

"There is epidemiological evidence that physical activity (PA) is associated with reduced risk of cardiovascular disease [CVD] and cardiovascular mortality; however, the mechanisms underlying the protective effect of PA are many and [are] not fully understood," write Kristi L. Storti, PhD, MPH, from the University of Pittsburgh, Graduate School of Public Health, in Pennsylvania, and colleagues. "For example, PA is believed to have beneficial effects on CVD risk factors, such as insulin sensitivity [and] blood pressure.... The aim of this study was to examine the association between [PA] and [CAC] among two cohorts of postmenopausal (PM) women representing early and late postmenopause." In addition, CVD is the leading cause of death in women, and the incidence of CVD increases dramatically after menopause. According to the authors, two thirds of women who die each year from a catastrophic cardiac event were asymptomatic. For this reason, looking for "subclinical measures that may predict possible future events" is crucial.

The investigators studied the cross-sectional relationship between PA and CAC in 173 younger PM women and in 121 older PM women for whom complete PA and CAC data were available. The former group was enrolled in the Women On the Move through Activity and Nutrition (WOMAN) study (mean age, 56.8 ± 2.9 years), and the latter group in the Walking Women Follow-up (WWF) study (mean age, 73.9 ± 3.8 years). In both cohorts, PA during a 7-day period was measured objectively with a pedometer, and CAC was evaluated by electron beam tomography.

Detectable CAC (0 vs > 0) was present in 57% of WOMAN study participants and in 74% of WWF study participants. For participants in the WOMAN study, median CAC score was 1.4 (interquartile range [IQR], 0 - 23.3) compared with 38.8 (IQR, 0 - 264.4) in WWF study participants.

Median step counts per day were 6447 (IQR, 4823 - 8722) in the WOMAN study and 5466 (IQR, 3610 - 7576) in the WWF study. Pedometer steps were inversely associated with CAC (P for trend = .002) among WWF study participants, but there was no association among WOMAN study participants.

Limitations of this study include cross-sectional design, inability of the pedometer to accurately measure nonambulatory activities such as resistance training and cycling or to measure water activities, reporting errors or lack of data if participants did not accurately record their step counts from the pedometer in their 7-day activity diary, and lack of generalizability to more diverse populations.

"Among older postmenopausal women, higher levels of PA were associated with lower CAC. However, this relationship was not observed in younger postmenopausal women, and was probably a result of the lower prevalence of CAC in this age group. These findings warrant future research examining the role of PA and the progression of CAC in early postmenopausal women," the study authors conclude.

Support was provided by the National Institutes of Health (Walking Women Follow-up study) and the National Heart, Lung, and Blood Institute (Women on the Move Through Activity and Nutrition study). The study authors have disclosed no relevant financial relationships.

Menopause. 2010;17:1146-1151. Abstract


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