Abstract Body (Do not enter title and authors here): Introduction: Current guidelines recommend 500-1000 metabolic equivalent minutes per week (METs-min/wk) of physical activity (PA) to reduce cardiovascular (CVD) risk. Interestingly, studies (DeFina 2019, Aengevaeren 2017) have found an association between high PA and subclinical coronary artery atherosclerosis (CAD) cross-sectionally by coronary artery calcium score (CAC). However, Shuval et al (2024) did not find this association. We aim to investigate the association between PA and CAC in the ELSA-Brasil cohort.

Methods: We analyzed cross-sectionally data of 2711 asymptomatic statin-free individuals without prior CVD or inflammatory disease from the ELSA-Brasil cohort. PA and CAC were examined by unadjusted and adjusted (age, sex, race) regression. PA and CAC were used as both continuous (log-transformation) and categorical variables to evaluate the results' robustness. For visual illustration, raw data, unadjusted, and adjusted regressions were plotted.

Results: The mean age was 50±8, 53% (1433/2711) were female, 15% (387/2577) and 61% (1573/2577) were black and white, respectively. CAC = 0, CAC 1 – 100, and greater than 100 in
2001/2711 (73.8%), 485/2711 (17.9%), and 225/2711 (8.3%), respectively. PA (METs-min/wk) 0 – 500, 500 – 1000, and higher than 1000 in 66.3% (1797/2711), 13.8% (367/2711), and 16.2% (441/2711), respectively. In unadjusted regression (similar using categorical or continuous both CAC and PD), PA was associated with CAC (OR = 1.06, 95% CI: 1.02-1.10, p=0.005) but this association was not found when adjusted to age, sex, and race (table, graphic).

Conclusions: A high volume of physical activity was not associated with CAC after adjustment for age, sex, and race in relatively young asymptomatic statin-free individuals from the ELSA-Brasil cohort without prior CVD.