Key result
High-volume exercise in middle-aged athletes is associated with a higher prevalence of coronary artery calcification but a more benign, calcified plaque morphology and lower mortality.
Why the study?
Recent studies reported a higher prevalence of coronary artery calcifications and atherosclerotic plaques in athletes compared to less active controls, raising questions regarding assessment, plaque characteristics, exercise intensity, sex differences, and clinical management.
While extreme exercise may increase the prevalence of coronary calcification, the plaque morphology is more stable and overall mortality remains lower, suggesting athletes should not be deterred from exercising.
Answers are grounded in this paper and cite their sources.
May support continued high-volume exercise in middle-aged athletes; leaves open need for prospective trials on plaque progression.
Regular exercise training is considered healthy as it reduces the risk of cardiovascular events and mortality. Nevertheless, athletes are not immune to the development of cardiovascular diseases and recent studies reported a higher prevalence of coronary artery calcifications and atherosclerotic plaques in athletes compared to less active controls. These observations have raised many questions among sport scientists, sports cardiologists, amateur athletes, and the general population. For example, Are athletes (not) immune for coronary atherosclerosis? How to assess coronary atherosclerosis in athletes? What about chalk (calcified plaque) and cheese (mixed plaque)? Does exercise intensity play a role? Are there sport-related differences? Are there sex differences? Can sports medical evaluation detect coronary atherosclerosis? Do athletes get worried? Should athletes get worried? How should athletes with coronary atherosclerosis be managed? The goal of this review is to discuss the latest scientific insights and to answer these important questions. Furthermore, we will explore potential clinical implications and point out directions for further research.
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Aengevaeren et al. (2020) conducted a review in Coronary atherosclerosis. Regular high-volume exercise training vs. Less physically active controls was evaluated. High-volume exercise in middle-aged athletes is associated with a higher prevalence of coronary artery calcification but a more benign, calcified plaque morphology and lower mortality.
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