High-Volume Exercise Linked to Increased Coronary Artery Calcification Scores

Recent research published in the June issue of JACC: Advances suggests that male athletes engaging in high-volume endurance exercise may develop a greater burden of calcified plaque in their coronary arteries compared to nonathletes. The study, led by Dr. Ahmed Abdelaziz from the Medical Research Group of Egypt at the Negida Academy in Arlington, Massachusetts, analyzed data from nine observational studies involving over 61,000 participants to understand how different levels of physical activity impact coronary atherosclerosis.

The findings revealed that male athletes who exercised beyond 3,000 MET-minutes per week exhibited significantly higher average coronary artery calcification (CAC) scores—showing a mean difference of approximately 32 points—when compared to their less active or nonathlete counterparts. Conversely, athletes engaging in 1,500 to 3,000 MET-minutes weekly did not show an increased CAC score, indicating a potential threshold effect in the relationship between exercise volume and arterial calcification. Interestingly, no such association was observed among female athletes, highlighting sex-specific differences in heart health responses to high-volume training.

These results raise important questions about the long-term cardiovascular implications of high-frequency endurance exercise. Experts emphasize the need for future high-quality longitudinal studies to determine whether increased calcification translates to higher cardiovascular risk and to establish optimal exercise thresholds. The study underscores the importance of personalized exercise regimens and careful monitoring for athletes engaged in high-intensity, high-volume training sessions.

While regular physical activity is broadly beneficial, this research suggests that excessive endurance exercise may carry unintended cardiovascular effects for certain populations. Healthcare professionals are encouraged to consider these findings when advising athletes and highly active individuals on their fitness routines.

Source: https://medicalxpress.com/news/2025-05-high-volume-coronary-artery-calcification.html