Key result
Recreational endurance running over 40 linked to ~0.3-cm wider ascending aorta.
Why the study?
Endurance exercise remodels large arteries, but whether a recreational training dose is sufficient to induce this remodeling in under-represented masters runners over 40 years was unclear.
Does recreational endurance running (≥20 km/week for ≥1 year) increase ascending aortic diameter and alter the vascular profile compared to a sedentary lifestyle in adults over 40 years free of cardiovascular disease?
Cross-Sectional (n=69)
Assessor-blinded
No
Does recreational endurance running (≥20 km/week for ≥1 year) increase ascending aortic diameter and alter the vascular profile compared to a sedentary lifestyle in adults over 40 years free of cardiovascular disease?
Mean Difference: 0.31 (95% CI 0.13–0.49)
Absolute Event Rate: 3.25% vs 2.9%
p-value: p=0.001
Recreational masters runners over age 40 exhibit a modestly wider ascending aorta (+0.31 cm adjusted) compared to sedentary peers, remaining strictly within normal clinical limits (<4.0 cm) and without altered collagen turnover, suggesting benign physiological remodelling rather than pathological aortopathy.
No change to exercise advice for masters runners; leaves open whether endurance training causes clinically meaningful aortic dilation.
Purpose Endurance exercise remodels the large arteries, but whether a recreational training dose is sufficient to induce such remodelling is unclear. Masters recreational runners over 40 years are under-represented in this research. We compared the ascending aortic diameter and vascular profile of these runners with sedentary controls of similar age. Methods This cross-sectional study included 42 masters recreational runners (at least 20 km per week for at least one year) and 27 sedentary controls, all over 40 years, free of cardiovascular disease and without bicuspid aortic valve or connective tissue disorder. We measured the ascending aortic diameter and left ventricular function by transthoracic echocardiography, and brachial-ankle pulse wave velocity (baPWV) and the ankle-brachial index (ABI) by oscillometry. Circulating collagen-turnover markers (CTX-I, MMP-2) were assayed. The aortic diameter was compared between groups by regression. Results The ascending aorta was wider in runners (3.25 vs. 2.90 cm; p = 0.001; Cliff’s delta 0.45). The difference persisted after adjustment for age, sex and height (beta 0.31 cm; p = 0.001) and in sensitivity analyses. No aortic diameter reached 4.0 cm; all remained within normal limits. The ABI was higher in runners (1.07 vs. 1.03; p = 0.007), and baPWV did not differ ( p = 0.069); both stayed within normal limits. CTX-I and MMP-2 did not differ, and left ventricular function was preserved. Conclusion These findings are consistent with modest, exercise-associated aortic remodelling rather than overt aortopathy in recreational masters runners over 40 years.
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Sacharczuk et al. (2026) conducted a cross-sectional in Ascending aortic remodelling in masters recreational runners (n=69). Recreational endurance running (≥20 km/week for ≥1 year; median 37.5 km/week) vs. Sedentary controls (<150 min/week incidental activity, no regular endurance training) was evaluated on Ascending aortic diameter (cm) (Adjusted beta 0.31 cm (Hodges-Lehmann median difference 0.30 cm; Cliff's delta 0.45), 95% CI 0.13 to 0.49, p=0.001). Recreational endurance running in adults over 40 years was associated with a wider ascending aorta than in sedentary controls (3.25 vs 2.90 cm; adjusted beta 0.31 cm, p=0.001), within normal limits.
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