Physical activity and progression of carotid intima-media thickness in patients with coronary heart disease

SummaryObjectiveWe conducted the present study to determine the level of physical activity required to retard the progression of carotid intima-media thickness (IMT) in patients with coronary heart disease (CHD).Patients and main outcome measurementsThe daily walking distance (km/day) of 40 patients with CHD (male/female ratio: 37/3, mean age: 61.2 years, mean interval time after a coronary event 16.2 months) was examined. Carotid IMT examinations (B-mode ultrasonography) were performed at the baseline and after 6 months.ResultsAmong the patients, the average walking distance was 4.00 km/day. Walking distance was inversely associated with IMT progression (r = −0.51, p < 0.01). Multivariate logistic regression analysis revealed that walking distance (p = 0.024) is a predictor for IMT progression independent of classical cardiovascular risk factors. Receiver operating characteristic analysis showed that the walking distance of 4.25 km was strongly predictive of IMT preservation (sensitivity 64.0%, specificity 73.3%) in CHD patients.ConclusionsOur data suggested that an increase in the daily walking distance could retard the progression of carotid IMT in patients with CHD. Cardiology medical staff should encourage their patients to expend an average of 4–5 km in daily walking distance for the secondary prevention of cardiovascular disease.