Exercising Leads to a Longer Life, Even If You Have Plaque in Your Arteries
People who have significant atherosclerosis (hardening of the arteries), but are highly active have death rates similar to those who have little or no atherosclerosis but don’t exercise, according to a study published Mayo Clinic Proceedings: Innovations, Quality and Outcomes.
Previous research has found ultra-endurance athletes have higher levels of atherosclerosis than average. But they may have more stable plaque, putting them at a lower risk for cardiovascular disease.
Atherosclerosis—the hardening and narrowing of the arteries—can pave the way for death and disease in the form of arrhythmias, heart attack, stroke, chronic kidney disease, and other health conditions.
But people with atherosclerosis who exercise regularly are no more likely to die from any cause than people who don’t exercise and whose arteries are free from disease, according to a study published in Mayo Clinic Proceedings: Innovations, Quality and Outcomes.
Doctors screen for atherosclerosis using a test known as a coronary artery calcium (CAC) scan, which measures the amount of plaque build up in your arteries. CAC scores from this scan range from 0 to >400. Generally speaking, the higher your CAC score, the more likely you are to develop heart disease or have a heart attack or stroke.
However, in the new study, Mount Sinai Health System researchers found that people who exercised regularly had significantly lower risk than their CAC scores would generally suggest.
In the study, the investigators analyzed health data from 2,318 adults between the ages of 65 and 84 who had underwent CAC scanning between the years of 1998 and 2016. Before the scan, the volunteers had also filled out a questionnaire that included a line item asking them to rate how much they exercised on a 0 to 10 scale with 0 being, none and 10 being always. A score of 0 to 2 was considered low activity; 3 to 7 was moderate activity, and 8 to 10 was high exercise activity.
When researchers looked at the death rate of the participants over a 10-year period, they found that those who reported less physical activity had higher death rates (2.9 percent per year) compared to those who said they were more physically active (1.7 percent per year).
What was most striking, however, is the participants who had significant atherosclerosis (CAC scores greater than 400), but who also reported high levels of physical activity had death rates similar to those who had little to no atherosclerosis (CAC scores of only 0 to 99), but also said they didn’t exercise often.
This study is even more interesting when juxtaposed with research published in the same journal last year that reported significantly higher rates of atherosclerosis (CAC scores great than 100) in long time marathon and ultra distance runners compared to those who ran shorter distances and national averages.
“There are a number of recent studies that suggest that extreme exercise may make some individuals more prone to developing coronary atherosclerosis, with accompanying build up of coronary artery calcium (CAC),” Alan Rozanski, M.D., author of the most recent study and professor of cardiology at the Icahn School of Medicine at Mount Sinai, told Bicycling.
“At the same time, being physically active appears to decrease an individual’s risk for developing overt heart disease for any level of coronary calcium build-up,” Rozanski says.
Though more research is needed to fully understand what’s going on here, data suggests that exercise may be protective, even in the presence of atherosclerosis, by changing the nature of the plaque, Rozanski says.
“Exercise may serve to be protective against atherosclerosis by promoting the decrease in lipid volume of coronary plaques as well as other changes that promote plaque stabilization and make them less likely to rupture,” he says.
In other words—as an endurance athlete, you may have a different type of plaque in your arteries. You may have plaque that is rich in calcium and more stable, so it is less likely to cause problems like heart attack.
In the end, your CAC score is just one piece of a larger picture of your cardiovascular health, Rozanski says.
“If CAC is detected, it indicates the presence of subclinical heart disease [aka disease that has no recognizable symptoms], and this would then certainly call for the aggressive treatment of any underlying coronary risk factors, such as high cholesterol or high blood pressure,” Rozanski says
“However, discontinuing exercise is not recommended. Whether an extreme exerciser who has considerable CAC should also lower his or her volume of exercise is a nuanced question that should be addressed by consulting one’s physician,” he says.
You Might Also Like
