Even if you get more clogs in your arteries from super intense training, you’re still less likely to die from heart problems than someone who doesn’t exercise at all.

High-intensity endurance exercise, when accumulated over long durations, is associated with a significantly increased prevalence of coronary artery plaque, an association not detected using self-reported exercise metrics.

Chronic high-volume endurance exercise is associated with the development of calcified coronary artery plaque, which is biomechanically more stable and less prone to rupture than non-calcified or mixed plaque.

Men who have trained for decades as elite endurance athletes, like cyclists or marathoners, tend to have more fatty deposits in their heart arteries than healthy men who exercise moderately—even when both groups are fit and have normal cholesterol and blood pressure.

The association between cumulative exercise volume and coronary plaque burden is significantly amplified when the volume includes a high proportion of high-intensity training sessions.

People who train hard and regularly for endurance sports are less likely to have dangerous, unstable plaque in their heart arteries that could suddenly cause a heart attack.