Abstract P442: Apparently Healthy Fit Asymptomatic Adults Are Not Immune To Sub-clinical Atherosclerosis
Evidence suggests that cardiovascular (CV) fitness below the 20th percentile for age and gender is associated with increased cardiac death and all cause mortality. This study assessed the association between CV fitness and sub-clinical atherosclerosis (SCA) in a self-selected group of participants in a cardiology-based prevention program. The study involved a single visit observation of participants. 240 apparently healthy asymptomatic adults <65 years (69% male) received a maximal graded exercise stress test and a carotid intima-media thickness (CIMT) evaluation with B-mode ultrasound. CV fitness was classified based on age-gender norms (very poor=1-19th, poor=20-39th, fair=40-59th, good=60-79th, excellent/superior=80-100th percentile). CIMT was used to define CV health based on age-gender-race norms. SCA was considered present when there was non-occlusive carotid artery plaque (>1.5mm and >50% of the surrounding intima-media) or CIMT >75th percentile. Anyone with a prior history of clinically apparent atherosclerosis or diabetes was excluded from the study. The mean age of participants was 50 yrs (SD= 8.7). 113 participants (47%) had excellent/superior CV fitness. 41 (17%) were classified good, 36 (15%) fair, 20 (8%) poor and 30 (12%) very poor. 69 (61%) participants with excellent/superior CV fitness had advanced atherosclerosis (plaque=43%; n=49 or CIMT >75th percentile=l7%; n=20). In the good classification there were 26 (64%) with plaque (49%; n=20) or CIMT >75th percentile (15%; n=6). There were 23 (63%) in the fair classification with plaque (44%; n=16) or CIMT >75th percentile (19%; n=7), 11 (55%) in the poor classification with plaque (45%; n=9) or CIMT >75th percentile (10%; n=2) and 17 (56%) in the very poor classification with plaque (53%; n=16) or CIMT >75th percentile (3%; n=1). 58 (24%) of the total number of participants were classified with superior CV fitness (95-100th percentile); of which 36 (62%) had SCA (plaque=45%; n=26 or CIMT >75th percentile=17%; n=10). In this self-selected population, CIMT testing detected evidence of SCA across all age-gender fitness classifications, which included very fit individuals. Further investigation is needed to identify other factors that may be associated with increased CV risk in apparently healthy fit asymptomatic adults.
Author Disclosures: R. Scales: None. K.A. Cornella: None. M. Vardhini: None. C. Akalan: None. Q. Wu: None. S. Halli: None. R.T. Hurst: None.
- © 2014 by American Heart Association, Inc.