Don’t quit running — but still check your cholesterol and blood pressure, even if you’re super fit.

High-volume, high-intensity endurance exercise increases coronary artery plaque burden without increasing all-cause or cardiovascular mortality risk in otherwise healthy individuals.

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.

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.