Coronary artery calcification and high-volume physical activity: role of lower intensity vs. longer duration of exercise
Abstract
Aims While high-volume physical activity (PA) has been linked to elevated coronary artery calcification (CAC), the role of intensity vs. duration of PA has not been investigated. The purpose of the study was to examine the role of intensity vs. duration of PA in relation to CAC. Methods and results Data are from 23 383 apparently healthy men who completed a PA questionnaire and underwent CAC scanning as part of a preventive examination. Self-reported PA was categorized into four groups of average intensity and weekly duration of PA [average intensity: 1, 3-5.9, 6-8.9, and 9-12 metabolic equivalents of task (METs); weekly duration: 0, > 0- Conclusion Elevated CAC was associated with lower average intensity and longer duration of PA in men, providing new insight into the complex relationship between leisure-time PA behaviours and risk of CAC.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Previous studies examining the link between training characteristics and CAD have yielded conflicting results, probably resulting from differences in training load definitions and measurement approaches.
“Previous studies examining the link between training characteristics and CAD have yielded conflicting results, probably resulting from differences in TL definitions and measurement approaches.12–14”
Pavlovic et al found an association between high-duration, low-intensity training and CAC, but used an even lower threshold for "high intensity" (>6 METs).
“Similarly, Pavlovic et al found an association between high-duration, low-intensity training and CAC, but used an even lower threshold for “high intensity” (>6 METs).”
These limitations underscore the need for more nuanced training load metrics in highly trained cohorts.
“These limitations underscore the need for more nuanced TL metrics in highly trained cohorts.13”
Cites
The Physical Activity Guidelines for Americans
Piercy, K. L., Troiano, R. P., Ballard, R. M., Carlson, S. A., Fulton, J. E., Galuska, D. A., George, S. M., & Olson, R. D. (2018) · JAMA · doi:10.1001/jama.2018.14854 · Cited by 9,755 · see citing works
Blood Lipid and Lipoprotein Adaptations to Exercise: A Quantitative Analysis
Durstine, J. L., Grandjean, P. W., Davis, P. G., Ferguson, M. A., Alderson, N. L., & DuBose, K. D. (2001) · Sports Medicine · doi:10.2165/00007256-200131150-00002 · Cited by 588 · see citing works
Relationship between lifelong exercise volume and coronary atherosclerosis in athletes.
Aengevaeren, V. L., Mosterd, A., Braber, T. L., Prakken, N. H. J., Doevendans, P. A., Grobbee, D. E., Thompson, P. D., Eijsvogels, T. M. H., & Velthuis, B. K. (2017) · Circulation · doi:10.1161/circulationaha.117.027834 · Cited by 309 · see citing works
Lifelong endurance exercise and its relation with coronary atherosclerosis
De Bosscher, R., Dausin, C., Claus, P., Bogaert, J., Dymarkowski, S., Goetschalckx, K., Ghekiere, O., Van De Heyning, C. M., Van Herck, P., Paelinck, B., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad152 · Cited by 140 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Coronary atherosclerosis in athletes: emerging concepts and preventive strategies
Claessen, G., Eijsvogels, T. M. H., Albert, C. M., Baggish, A. L., Levine, B. D., Marijon, E., Michos, E. D., & La Gerche, A. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehae927 · Cited by 43 · see citing works
Self-citationPauwels, R., Dausin, C., Ruiz-Carmona, S., De Bosscher, R., De Paepe, J., Bekhuis, Y., Delpire, B., Sinnaeve, P., Dymarkowski, S., Ghekiere, O., et al. (2026) · Circulation · doi:10.1161/circulationaha.125.077117 · Cited by 3 · see citing works
- Authors
- Pavlovic, A., DeFina, L. F., Leonard, D., Radford, N. B., Farrell, S. W., Barlow, C. E., Shuval, K., Berry, J. D., & Levine, B. D.
- Affiliations
- Cooper Institute (US)
- Cooper Clinic (US)
- The University of Texas at Tyler (US)
- Texas Health Dallas (US)
- Corresponding author
- Pavlovic, Andjelka
- ORCID
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2024-04-23
- Volume
- 31
- Issue
- 12
- Pages
- 1526-1534
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W4395027357
- Cited by
- 20
- References
- 4
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 5
- FWCI
- 5.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- coronary artery calcification, physical activity intensity, exercise duration, leisure-time physical activity, metabolic equivalents, Agatston units, cardiovascular risk, men
- MeSH terms
- Computed Tomography Angiography, Adult, Coronary Artery Disease, Cross-Sectional Studies, Humans, Male, Middle Aged, Risk Factors, Time Factors, Exercise, Coronary Angiography, Risk Assessment, Risk Reduction Behavior, Vascular Calcification, Protective Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
