Carotid atherosclerosis is the leading cause of ischemic stroke. Carotid intima–media thickness (cIMT) is a validated surrogate marker of atherosclerosis that is independently associated with the risk for cardiovascular disease. It’s presence in the general population has been well documented, with one study showing that among nearly 15,000 participants, mean cIMT was 0.74 (0.11) mm, with almost 40% having cIMT >1 mm and documentable early atherosclerotic lesions. Lifestyle modification may be key to treating subclinical atherosclerosis as it affects vascular and endothelial function. However, recent studies on the effect of exercise on cIMT have yielded conflicting results. These researchers undertook a systematic review and meta-analysis to summarize the current evidence regarding the effects of exercise on cIMT in adults and determine the impact of the 3 characteristics of exercise (duration, intensity, and type) on cIMT.
Their review included 26 studies with 1370 participants. Compared with control participants, those who engaged in exercise showed a decline in cIMT (weighted mean difference [WMD] −0.02; 95% Confidence Interval [CI], −0.03 to −0.01; I2 = 90.1%). Participants who engaged in aerobic (WMD −0.02; 95% CI, −0.04 to −0.01; I2 = 52.7%) or resistance (WMD −0.01; 95% CI, −0.02 to −0.00; I2 = 38.5%) exercise showed lower cIMT compared with control participants. An exercise duration of >6 months was associated with a 0.02 mm reduction in cIMT. In participants with low cIMT at baseline (<0.7 mm), exercise alone was not associated with a change in cIMT (WMD −0.01; 95% CI, −0.03 to 0.00; I2 = 93.9%).
The authors’ findings suggest that aerobic exercise with a minimum duration of 6 months was associated with reduced cIMT in adults. Aerobic exercise is associated with a greater decline in cIMT than other forms of exercise. The authors also called for large, multicenter, randomized controlled trials to establish optimal exercise protocols for improving the pathological process of atherosclerosis.
Source: Wang Y, Wu H, Sun J, et al. Effect of exercise on carotid artery intima-media thickness in adults: a systematic review and meta-analysis. J Phys Act Health. 2022;19(12):855-867. doi: 10.1123/jpah.2022-0372.
