The Relationship of Heavy Exercise and Coronary Artery Calcification

Heavy exercise is linked to coronary artery calcification

New information published in the Journal of the American Medical Association (JAMA) reports that those who engage in continuous strenuous exercise, such as training for marathons, show an increased level of coronary artery calcification (CAC). While such strenuous activity does produce more calcium in the artery, no significant increase was shown in mortality. Although no correlation was drawn with CAC among heavy exercisers and death, testing is strongly recommended for those with active exercise regimens.

The study focused on high-volume endurance activity of one hour or more per day. That type of activity is common among athletes and people training for a specific event. The study results show that most people who exercise heavily are safe to continue to do so. But testing could help determine if any risk is present.

What Coronary Artery Calcification Does

The buildup of calcium in the artery helps to create plaque, or an accumulation of unwanted substances that block proper blood flow. Without an adequate blood supply, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. There is a difference between this calcium and that found in bones.  The accumulation of cholesterol and plaque along the artery walls is called atherosclerosis. The most common cause of coronary artery disease (CAD), atherosclerosis can physically clog the artery or cause it to function abnormally. It can begin during childhood when streaks of fat appear in arteries. Chronic CAD is the slow build-up of plaque in arteries over time. The unwanted material in the arteries makes the heart work harder to get the blood they carry. The strain on the heart can cause arrhythmia (irregular heartbeat) or heart failure.

Acute coronary syndromes are caused suddenly. A blood clot could block the supply of blood to the heart muscle. This is called coronary occlusion and could cause one of three serious conditions. All acute coronary syndromes require immediate medical attention.

CAC Testing

New cholesterol guidelines released in 2018 recommend CAC testing for people ages 40 to 75 when determining proper cardiovascular programs and treatment. Now, with the results of the study drawing a connection between those involved in heavy workouts and calcification, it is also recommended for them. Once risk level is assessed, treatment and physical activity levels can be more accurately prescribed and recommended.

A CAC test involves a computed tomography scan, commonly known as a CT scan. A cross-section of images of the blood vessels is created to determine the density of plaque. These images help a cardiologist determine the level of risk of atherosclerosis or other possible problems that may currently exist or possibly develop in the future. The amount of radiation involved in a CAC test is comparable to the exposure level of a mammogram.

Different CAC test levels or “scores,” point to the amount of risk. A CAC score of less than 99 shows that calcium is beginning to accumulate but may be at a low level. The lower the score is, the lower the risk of CAC. If the score is above 100, statins should be considered, according to the study. Statins are drugs designed to reduce cholesterol.

CAC testing is comparatively new. However, it is being recognized as an accurate way to determine the amount of calcium in the arteries and cardiologists expect to see more usage as time goes forward. In addition to those who engage in heavy workout schedules, others at risk for coronary artery disease will also benefit from the results of the test.

It is important to inform a physician or cardiologist before beginning any intense exercise program.

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