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Extreme Exercise Not a Threat to Athletes

Extreme Exercise Not a Threat to Athletes

Written by Dr. Lakshmi Venkataraman, MD
Medically Reviewed by 
The Medindia Medical Review Team on February 1, 2019 at 6:31 PM
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  • High volume and high-intensity athletes are not at higher risk of heart disease or mortality despite having higher levels calcium in their hearts
  • The health benefits of exercise including control of heart disease, diabetes and other medical conditions significantly outweigh the minor risk of slightly higher coronary calcium
  • High-volume, high-intensity exercise includes a minimum of five to six hours per week at a rate of 10 minutes per mile

Regular high volume and high-intensity exercise does not increase the risk of heart disease or death and has many health benefits according to a recent collaborative study conducted by the University of Texas Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas. The study was led by Sports cardiologist Dr. Benjamin Levine, a Professor of Internal Medicine and Director of the Institute for Exercise and Environmental Medicine.

"The question has never been whether exercise is good for you, but whether extreme exercise is bad for you. For the past decade or so, there's been increasing concern that high-volume, high-intensity exercise could injure the heart. We found that high volumes of exercise are safe, even when coronary calcium levels are high," said Dr. Levine.

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Extreme Exercise Not a Threat to Athletes

The findings of the study appear in the journal JAMA Cardiology.

Effects of High Volume, High-Intensity Exercise on Heart

It is widely believed that high-intensity exercise can damage the heart. The study was carried out to test the effects of high-intensity on the heart as well as other effects.

For the study, data were obtained from the Cooper Center Longitudinal Study.
  • Around 21,758 generally healthy men between the ages of 40 to 80 years without heart disease were followed up for the occurrence of death between 1998 and 2013
  • Most of the participants were middle-aged and reported their fitness and physical activity levels and were subject to coronary calcium scanning
  • The participants consisted of mostly runners, but some were cyclists, rowers or swimmers. A small proportion engaged in more than one activity
  • Women were excluded from the study as their death rates are lower than for men
  • The majority of the high-intensity athletes had low levels of coronary calcium, though they were more likely to have higher levels, approximately 11 percent more than men who exercised less
  • However, most importantly, the study found that higher coronary calcium scores did not increase the risk of death due to heart disease or any other cause

What is Coronary Calcium and Coronary Calcium Scanning?

Coronary calcium is a marker of atherosclerosis, a condition in which plaque builds up in the walls of the coronary vessels supplying the heart and can result in heart attack or stroke. If coronary calcium is found in the heart, it indicates that blood vessel narrowing has begun.

Coronary calcium scanning is an imaging test to determine the amount of calcium that is deposited in the heart and its blood vessels. It helps doctors to classify patients who are otherwise healthy without cardiac symptoms as low, intermediate, or high risk for an adverse heart event e.g heart attack. Based on the results of the scan, the doctor can initiate interventional measures such as medications, lifestyle changes or both.

Takeaways From the Study

  • Exercise is safe and the benefits of intense exercise outweigh the risks
  • Exercise alone cannot be a substitute to reduce heart disease risk if bad habits such as smoking and poor diet are not addressed
  • When starting high-intensity exercise, make a longterm plan and slowly and gradually increase the intensity and volume of exercise
  • High-intensity athletes should regularly review their heart disease risk with their doctors to provide and establish clinical guidelines
"The known benefits of regular physical activity in the general population include decreased mortality, heart disease, diabetes, and many other medical conditions which reminds us how important it is to participate in regular physical activity as recommended by the 2018 Physical Activity Guidelines," said Dr. Laura DeFina, Chief Scientific Officer of The Cooper Institute and co-author of the study.


High-intensity exercise is safe and the benefits significantly outweigh small the risk of slightly higher coronary calcium.

Reference :
  1. Association of All-Cause and Cardiovascular Mortality With High Levels of Physical Activity and Concurrent Coronary Artery Calcification - (http://dx.doi.org/10.1001/jamacardio.2018.4628)

Source: Medindia

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