Aerobic fitness is associated with low cardiovascular disease risk: The impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - The Lifestyle, Biomarker, and Atherosclerosis study

I was incredibly fit and still suffered an ischemic stroke, of course the carotid dissection probably occurred during exertions on my 6 day, 21 mile whitewater canoe trip, with portages up to 1.5 miles. My extreme fitness caused my stroke but also probably saved my life after the stroke occurred.
https://www.mdlinx.com/internal-medicine/medical-news-article/2017/03/30/cimt-cholesterol-insulin-resistance-body-fat/7108753/?

Vascular Health and Risk Management

Fernstrom M, et al.

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The objectives of the study portrayed in this paper were to evaluate selected cardiometabolic biomarkers, carotid intima–media thickness (cIMT) as a marker of subclinical atherosclerosis, and lifestyle–associated indicators (food habits, handgrip strength, and oxygen uptake, VO₂ max); examine the relationship between cIMT and lifestyle factors; and recognize subjects at risk of cardiovascular disease (CVD) utilizing a risk score and to compare the characteristics of subjects with and without risk of CVD. High aerobic fitness is related to low CVD risk in Swedish young adults. The high prevalence of young adults observed with unfavorable levels of high–density lipoprotein cholesterol and homeostasis model assessment of insulin resistance raises concerns about future CVD risk.

Methods

• They collected blood samples in a fasting state, and food habits were reported through a questionnaire.
• In this study, cIMT was measured by ultrasound, and VO₂ max was measured by ergometer bike test.
• The risk score was calculated according to Wildman.

Results

• In this study, they found cIMT (mean ± standard deviation) was 0.50±0.06 mm, and VO₂ max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively.
• No correlation was found between aerobic fitness expressed as VO₂ max (mL/kg/min) and cIMT.
• By using Wildman’s definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance.
• An aggregate of 35% of women and 25% of men had lower high–density lipoprotein cholesterol than suggested.
• Food habits did not differ between those at risk and those not at risk.
• However, aerobic fitness measured as VO₂ max (mL/kg/min) differed; 47% of the subjects at risk had low aerobic fitness compared to 23% of the nonrisk subjects (P<0.001).