Vigorous exercise can damage heart, stick to moderate limits, study says

Exercise and physical activity definitely reduce the risk of cardiovascular disease (CVD), with many studies showing that an active individual has a 30 to 40 percent lower risk. However, the latest research has debunked the myth of unlimited exercise, overdoing it and pushing yourself too hard, recommending a moderate amount instead. A vigorous exercise regimen may actually promote calcification in the arteries, or atherosclerosis, in active middle-aged people.

A research paper published in the journal Circulation looked at the relationship between exercise volume and intensity and the progression of coronary risks in older male athletes. During a long follow-up period, exercise intensity was associated with progression of coronary atherosclerosis. According to the findings, “demanding intense exercise was associated with significantly higher atherosclerosis and calcified plaque progression. Exercise at a very high level of intensity has been associated with the formation of calcified plaque, suggesting that certain mechanisms may be involved in facilitating coronary atherosclerosis in athletes.’

Dr. Bimal Chhajer, cardiologist, ex-consultant of AIIMS and founder of SAAOL Heart Institute, explains: “There is a long-held belief worldwide that enormous amounts of physical activity and exercise reduce the risk of CVD and other related diseases. With ever-increasing new knowledge and research, it has now been established that while moderate physical activity can help reduce the risk of CVD, high-intensity exercise can lead to the progression of coronary atherosclerosis in middle-aged and older athletes. Certain exercises or exercises are known to overtax the heart, causing the body to produce higher levels of catecholamines, which increase an individual’s heart rate and blood pressure. A fast heart rate can accelerate atherosclerosis. Catecholamines are important stress responses present within the body and high levels of these stress responses can cause high blood pressure leading to several problems such as headaches, sweating, palpitations, chest pain and anxiety, all of which are triggers.

“Coronary atherosclerosis is a condition where plaque begins to form inside the inner walls of the arteries present in the heart. This plaque can be made up of fats, cholesterol and other substances in and on the walls of the arteries. Arteries are responsible for carrying oxygen-rich blood throughout the body, and this plaque build-up narrows the path for blood and reduces or blocks blood flow through the body. Eventually, due to this blockage of arteries and improper blood flow, an individual can suffer from various CHDs. Although exercise intensity is said to be related to the progression of coronary atherosclerosis, the volume or number of workouts has little or no impact on the human heart,” adds Dr. Chhajer.

He suggests moderation as the key to a healthy life. “There is no need to stress the body with several hours of high-intensity exercise when you can achieve the same results over a period of time with lower or moderate intensity exercise. Exercising the body too much when it is not prepared for it can lead to disastrous results, not only in the case of the heart, but otherwise.”

With regular screening, he says, “Plaque burden present in the heart can be diagnosed using several diagnostic tests. A biomarker for the amount of coronary atherosclerotic plaque and potential risk of cardiovascular events is coronary artery calcification (CAC), which can be measured using advanced diagnostic tests. Every individual is required to have regular screening to prevent such events.” Plaque can be measured using computed tomography (CT) and coronary CT angiography (CCTA) imaging techniques. This study is known as

MARC-2 (Measurement of the Risk of Cardiovascular Events in Athletes 2), continuation of the MARC-1 study (Measurement of the Risk of Cardiovascular Events in Athletes 1). The MARC-2 study included asymptomatic middle-aged and elderly men over 45 years of age and showed no abnormalities in their sports medical evaluation between May 2019 and February 2020. Individuals who underwent percutaneous coronary intervention during follow-up were excluded. Relevant information about the exercise characteristics of the participants was obtained through a validated questionnaire. This questionnaire focused on collecting information on the type of sport, frequency, duration of each sport (in years), duration of exercise and level of performance, i.e. recreational vs. competitive, studied cohorts.

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