Abstract 17767: Physical Activity, Vitamin D, and Incident Atherosclerotic Cardiovascular Disease in the Atherosclerosis Risk in Communities (ARIC) Study
Background: Individuals with higher physical activity (PA) have higher 25-hydroxyvitamin D [25(OH)D] levels, but whether a dose threshold exists is unknown. Moreover, both low PA and 25(OH)D deficiency [<20 ng/ml] are associated with increased risk of atherosclerotic cardiovascular disease (ASCVD); however, their joint association with ASCVD risk is unknown. We examined the interrelation between PA and 25(OH)D and evaluated vitamin D as a modifier of the relation between PA and ASCVD outcomes.
Methods: We studied 10,342 ARIC participants free of ASCVD, who had PA measured by the Baecke questionnaire at baseline (1987-1989), 25(OH)D measured at visit 2 (1990-1992), and were followed for ASCVD events from visit 2 through 2013. PA was converted to min/wk of moderate or vigorous exercise and categorized per AHA guidelines as recommended, intermediate, or poor. Incident ASCVD was defined as incident myocardial infarction, fatal coronary heart disease, or stroke. Multivariable-adjusted restricted cubic spline, Poisson, and Cox hazard models were used.
Results: The mean age of participants was 54±6 yrs; 57% were women and 21% black. Mean 25(OH)D levels were 25±9 ng/ml, 30% were 25(OH)D deficient, and ≤40% met AHA recommended PA. In spline models, a nearly linear association was seen between PA and 25(OH)D levels (Figure). Those meeting recommended PA were 28% less likely to have 25(OH)D deficiency (Table). Over a mean follow up of 19.3 yrs, 1800 incident ASCVD events occurred. An interaction was present between 25(OH)D and PA on ASCVD risk (p = 0.04). Among those with optimal 25(OH)D (≥30 ng/ml), those achieving intermediate and recommended PA (compared to poor) had ~30% reduced risk of ASCVD events, but the relationship of PA with ASCVD was not statistically significant in the intermediate and deficient vit D groups.
Conclusion: PA is linearly associated with higher 25(OH)D levels without a dose threshold, and vitamin D status modifies the association between PA and ASCVD risk.
Author Disclosures: K. Chin: None. D. Zhao: None. S.S. Martin: Honoraria; Modest; Abbott Nutrition, American College of Cardiology, Pew Research Center, Quest Diagnostics, Sanofi-Regeneron, Regeneron, Pressed Juicery. C.E. Ndumele: None. R. Florido: None. B.G. Windham: None. E. Guallar: None. P.L. Lutsey: None. E.D. Michos: Consultant/Advisory Board; Modest; Siemens Diagnostics.
- © 2016 by American Heart Association, Inc.