Why Do Some Athletes Have More Heart Plaque?
Sex Differences in the Impact of Exercise Volume on Subclinical Coronary Atherosclerosis
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Some super-fit male athletes who train extremely hard have more calcium buildup in their heart arteries, but it doesn't seem to hurt them. Female athletes, even super-fit ones, don't show this buildup — and might even have less than non-athletes.
Surprising Findings
Women with high-volume exercise had fewer calcified plaques than sedentary women, while men at the same volume had more.
Everyone assumes extreme exercise is either universally good or bad—but this shows it’s not just about volume, it’s about sex. Biology overrides the 'more is better' myth.
Practical Takeaways
Men: cap endurance training at 3,000 MET-min/wk (e.g., 5–7 hours/week of running/cycling) to maximize heart benefits without increasing plaque risk.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Some super-fit male athletes who train extremely hard have more calcium buildup in their heart arteries, but it doesn't seem to hurt them. Female athletes, even super-fit ones, don't show this buildup — and might even have less than non-athletes.
Surprising Findings
Women with high-volume exercise had fewer calcified plaques than sedentary women, while men at the same volume had more.
Everyone assumes extreme exercise is either universally good or bad—but this shows it’s not just about volume, it’s about sex. Biology overrides the 'more is better' myth.
Practical Takeaways
Men: cap endurance training at 3,000 MET-min/wk (e.g., 5–7 hours/week of running/cycling) to maximize heart benefits without increasing plaque risk.
Publication
Journal
JACC: Advances
Year
2025
Authors
Ahmed Abdelaziz, A. Elshahat, A. Gadelmawla, Muhammad Desouky, A. Hafez, Mohamed Abdelaziz, Noha Hammad, D. Eldosoky, Kirtipal Bhatia, A. Filtz, Daniel Lorenzatti, Toshiki Kuno, Salim S. Virani, M. Gulati, Michael D. Shapiro, Carl J. Lavie, Leandro Slipczuk
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Claims (6)
High-volume, high-intensity endurance exercise increases coronary artery plaque burden without increasing all-cause or cardiovascular mortality risk in otherwise healthy individuals.
Men who train extremely hard for endurance sports like marathons or triathlons for many years tend to have more calcium buildup in their heart arteries than men who exercise moderately, even though they’re otherwise healthy.
Women who train hard for endurance sports like marathons don’t show more calcium buildup in their heart arteries than women who don’t exercise much — and some evidence suggests they may have less.
Men who train extremely hard are more likely to have moderate levels of calcium in their heart arteries than men who train less, but women who train just as hard don’t show this increase.
Women who train hard for endurance sports — even very hard — tend to have less calcium buildup in their heart arteries than women who don’t exercise much.