Abstract 4129: Higher Levels of Cardiorespiratory Fitness are Associated with Lower Prevalence of Carotid Atherosclerosis in Hypertensive Men
Background. Carotid atherosclerosis is a risk factor for cardiovascular mortality and may represent hypertension related target organ damage. Cardiorespiratory fitness is inversely associated with cardiovascular mortality in hypertensive men. Therefore, we tested the hypothesis that higher levels of cardiorespiratory fitness are associated with lower prevalence of carotid atherosclerosis in a cross-sectional study of 2532 (age 53.2± 8.5 yrs) hypertensive men
Methods. Men with hypertension (defined as SBP/DBP ≥ 140/90 or self-reported use of antihypertension medication) underwent a maximal treadmill testing with expired gas analysis. Carotid atherosclerosis was defined as stenosis > 25% and/or intima-media thickness > 1.2mm using B-mode ultrasonography.
Results. The overall prevalence of carotid atherosclerosis was 13.4 %. The VO2peak that corresponded with fitness categories was as follows: low: ≤28.1ml/kg/min, moderate: 28.2 - 35.3ml/kg/min, and high: ≥35.4ml/kg/min. The prevalence of carotid atherosclerosis was inversely associated with fitness category (low; 22.5%, moderate; 10.9% and high; 8.7%, p<0.001). After adjustment for established risk factors (age, smoking, BMI, SBP, antihypertensive medication, TC/HDL-C ratio, WBC, fibrinogen, heart rate, diabetes), high and moderate fitness were associated with lower odds ratios for having carotid atherosclerosis 0.63 (95% CI, 0.47 - 0.85, p<0.001), and 0.62 (95% CI, 0.41 - 0.92, p<0.001), respectively, as compared with low fitness. Each one metabolic equivalent (1 MET) increment higher VO2peak was associated with 11% (OR = 0.89; 95% CI, 0.82 - 0.97, p<0.008) lower prevalence of carotid atherosclerosis in multivariate logistic regression analysis.
Conclusion. Hypertensive men with higher cardiorespiratory fitness had a lower prevalence of carotid atherosclerosis than men with lower fitness. Cardiorespiratory fitness may modify the development of target organ disease in hypertension.