; Exercise and Atherosclerosis. Ann Intern Med. 2004;141:890. doi: 10.7326/0003-4819-141-11-200412070-00022
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Published: Ann Intern Med. 2004;141(11):890.
The randomized, controlled trial conducted by Rauramaa and colleagues compared 6-year progression of carotid intima–media thickness between men assigned to usual activity and men assigned to a progressive aerobic exercise program. The modest-sized trial involved 140 middle-aged Finnish men randomly selected from a population registry; of these, 14% had incomplete follow-up data. Intention-to-treat analyses showed no clinically important or statistically significant differences in intima–media thickness progression between groups. A secondary analysis that excluded the few patients who were taking statins found a statistically significant difference in progression (P = 0.02). At 6 years, the average increase in intima–media thickness in the exercise group was 40% lower (absolute difference of 0.08 mm) than that in the control group. Strictly speaking, the correct conclusion that matches the study's original design and intention-to-treat analysis is what was reflected in the abstract and the Editors' Notes: Aerobic exercise did not attenuate or slow progression of atherosclerosis in the overall group of middle-aged men enrolled in the study. The subgroup findings suggested that exercise prevented atherosclerotic progression in some middle-aged men—those not taking statins. No formal analyses addressed whether exercise did or did not prevent progression in the small sample of men taking statins (n = 15); statistical power to address effects in this subgroup was low. As stated in the last paragraph of the paper, these findings support the concept that regular aerobic exercise probably helps prevent atherosclerotic disease in some men.
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