The bigger the rise in the bottom number of blood pressure (diastolic) during a hard race, the more likely an athlete is to have early heart artery plaque—even if their resting blood pressure is normal.

Athletes with early signs of heart artery plaque experience much higher blood pressure when pushing hard during a long bike race than athletes without plaque, meaning their hearts and blood vessels are under more strain.

Athletes with early heart artery plaque put more strain on their hearts during intense exercise, as shown by a higher number that combines heart rate and blood pressure—meaning their hearts are working harder than those without plaque.

For older male athletes who work out really hard—like sprinting or intense cycling—doing more of this super intense exercise over time seems to be linked to more calcium building up in their heart arteries, which could be a sign of plaque growth.

Men who have trained for decades in marathons and endurance sports are more likely to have calcium deposits in their heart arteries than men who don't exercise much—even if they're otherwise healthy and have no heart disease risk factors.

Doing very hard exercise — like sprinting or intense cycling — is linked to more calcium buildup and plaque in the heart arteries, even if the total amount of exercise is the same as someone who exercises less intensely.