The effects of long-term vigorous endurance exercise on the coronary arteries

doi:10.34045/ssem/2019/36

Abstract

Moderate endurance training is known to improve cardiovascular risk factors, and prolongs life expectancy. On the other hand, there has been some discussion whether “too much” exercise might have a contrarious effect by accelerating coronary atherosclerosis. The goal of this review was to evaluate the current literature on the effects of long-term vigorous endurance training on the coronary vasculature. In summary, data point to an increased calcium score, and a higher burden of atherosclerotic plaque in male athletes compared to sedentary controls. However, the plaques found in athletes were more prone to be calcified. The pathogenesis and clinical relevance of this athlete coronary artery disease phenotype remains incompletely understood and represents an area of important future work.

Highlights

Moderate intensity aerobic exercise training improves cardiovascular risk factors (CVRF), reduces the risk of incident coronary artery disease (CAD), and increases longevity [1,2,3,4]
While the health impact of exercise at higher intensities remains incompletely understood, available data suggest that people who perform vigorous physical activity reduce their risk of coronary artery disease [7]
Given that CVRF are influenced in a positive manner by exercise training, one would assume that long-term endurance athletes have a lower burden of CAD