Abstract MPTH63: Effects Of Exercise Training On Predicted ASCVD Risk: Meta-Analysis Across Eight Exercise Training Studies

Abstract

Background: Atherosclerotic cardiovascular disease (ASCVD) risk scores are commonly used to inform therapeutic strategies in the clinical setting. Although previous studies have shown that individual risk score components, such as HDL-C and total cholesterol, can be improved with regular exercise, few studies have investigated the effect of exercise interventions on composite measures of predicted ASCVD risk. Methods: Data from eight exercise trials (INFLAME; HART-D; CardioRACE; Queen’s; STRRIDEs 1, 2, and PD; HERITAGE) with 21 different interventions varying in exercise mode, amount, and/or intensity were analyzed. ASCVD risk scores were calculated for each participant (n=2,074) at baseline and after exercise training using the pooled cohort equations and Framingham Heart Study algorithm for 10- and 30-year risk, respectively ( Table 1 ). Meta-analysis of study group-specific mean changes in ASCVD risk with training was performed. When available, changes in exercise groups were compared against changes in the respective control group for each study. Since age is the strongest predictor of risk in the equations, additional meta-analysis was performed to examine changes in risk due to age only (phenotype levels held constant between time points), with all groups analyzed individually with no comparison to controls. Results: Exercise training resulted in an absolute decrease in 10-year ASCVD risk of -0.2% (95% CI: -0.3 to -0.1) and -1.2% (95% CI: -1.8 to -0.5) in 30-year risk, with low and high heterogeneity, respectively ( Figure 1 ). An increase in age only would have significantly increased 10- and 30-year risk across all exercise intervention groups by 0.3% (95% CI: 0.2 to 0.3), and 0.6% (95% CI: 0.5 to 0.7), respectively ( Figure 1 ). However, this age-related increase was abolished in all exercise groups except for the resistance training groups in STRRIDE 2 and CardioRACE. Conclusions: We found that a relatively short period of endurance exercise training of differing amounts and/or intensity performed alone or in combination with resistance training can prevent and even reverse the age-related increases in both short- and long-term ASCVD risk.