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Exercise is often cited as the best preventive medicine, but it's too much for the hearts of middle-aged athletes.
Dr. Benjamin Levine, a sports cardiologist, led a study, now published in JAMA Cardiology, to find the answer. Dr. Levine is Professor of Internal Medicine and Director of the Institute of Exercise and Environmental Medicine, a collaboration between the UT Southwestern Medical Center Medical Center and the Texas Health Presbyterian Hospital in Dallas.
What is coronary calcium badysis and why is it important?
Coronary calcium badysis is an imaging test that helps physicians categorize patients with no cardiac symptoms as low, medium or high risk for heart attack. It represents the amount of calcium (and therefore cholesterol deposits) accumulated in the blood vessels that supply the heart. The badysis can help doctors determine the need for medication, lifestyle modification and other risk-reducing measures.
"The question has never been whether exercise is good for you, but if an extreme exercise is bad for you. Over the past decade, there has been a growing concern that high-volume, high-intensity exercise can hurt the heart. We have found that high volumes of exercise are safe even when coronary calcium levels are high, "said Dr. Levine.
In this study, high volume and high intensity exercises were defined as at least five to six hours per week at a rate of 10 minutes per mile. The average amount of high intensity exercise in this group was eight hours a week.
Coronary calcium is the hallmark of atherosclerosis, a disease in which plaque builds up in the arteries and causes a heart attack and stroke. When coronary calcium is detected in the heart, the process of clogging in the blood vessels has begun. The majority of high-intensity athletes had low coronary calcium levels, although their likelihood of having higher rates was 11% higher than those of men who exercised less. More importantly, the researchers found that higher calcium scores did not increase the risk of cardiovascular or all-cause mortality in high intensity athletes.
Dr. Levine studied data from the Cooper Center longitudinal study. A total of 21,758 healthy men aged 40 to 80 years without cardiovascular disease were followed for mortality between 1998 and 2013. The athletes, the majority of whom were of average age, reported their Physical activity levels and underwent a coronary calcium badysis. Most were mostly runners, but some were cyclists, swimmers or rowers. A subgroup of athletes trained in three of these sports.
Women were not included in the study because their mortality rates are lower than those of men.
Despite the findings that extreme exercise does not increase the risk of heart disease, Dr. Levine recommends not using the protective effect of exercise to excuse bad lifestyle habits. "You can not defeat a lifetime of bad behavior – smoking, high cholesterol, high blood pressure – simply by doing intense physical activity. So do not use it as a magic cure, "said Dr. Levine, incumbent honourary. Science at UT Southwestern.
He also recommends caution when starting a new training program. "If you want to train for a marathon, you need a long-term plan to allow you to slowly grow before you reach these volumes and exercise intensity."
"The known benefits of regular physical activity in the general population include decreased mortality, heart disease, diabetes and many other medical problems, which reminds us of how important it is to participate in regular physical activity, as recommended by the 2018 Physical Activity Guidelines, "said Dr. Laura DeFina, chief scientist of the Cooper Institute and co-author of the study. "The current study does not show an increased risk of death in people who exercise at high volume and who have calcium in the coronary arteries. These people who practice a large volume of exercises should definitely review their risk of cardiovascular disease with their family doctor or cardiologist, and the results of the study provide useful clinical indications.
"The most important message for the public in practice is that large volumes of physical activity are safe. The benefits of exercise far outweigh the minor risk of having a little more coronary calcium, "said Dr. Levine.
This article has been republished from documents provided by the Southwestern Medical Center at the University of Texas. Note: Content may have changed for length and content. For more information, please contact the cited source.
Reference:
Defina, L. F., Radford, N.B., Barlow, C.E., Willis, B.L., Leonard, D., Haskell, W.L.,. . . Levine, B.D. (2019). Association of all-cause mortality and cardiovascular with high levels of physical activity and concomitant coronary calcification. JAMA Cardiology. doi: 10.1001 / jamacardio.2018.4628
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