No need for concern about increased death risk from heart disease among experienced middle-aged exercisers who engage in high-intensity activity, at least if they’re male. Findings from a 10-year study of 21,758 generally healthy, very active men—like marathon runners, cyclists and swimmers—showed that even for those with higher coronary-artery calcium levels, athletic pursuits did not elevate risk of death.

“The question has never been whether exercise is good for you, but whether extreme exercise is bad for you. For the past decade or so, there’s been increased concern that high-volume, high-intensity exercise could injure the heart. We found that high volumes of exercise are safe, even when coronary calcium levels are high,” said study author Benjamin Levine, MD, sports cardiologist, University of Texas Southwestern Medical Center, Dallas.

That said, people still need to review heart disease risks with their primary care doctor, and beginners need to build up to more strenuous activity levels. “The most important take-home message for the exercising public is that high volumes of exercise are safe. The benefits of exercise far outweigh the minor risk of having a little more coronary calcium,” said Levine.

The study is available in JAMA Cardiology (2019; 4 [2], 174-81).

Shirley Archer, JD, MA

Shirley Archer, JD, MA, is an internationally acknowledged integrative health and mindfulness specialist, best-selling author of 16 fitness and wellness books translated into multiple languages and sold worldwide, award-winning health journalist, contributing editor to Fitness Journal, media spokesperson, and IDEA's 2008 Fitness Instructor of the Year. She's a 25-year industry veteran and former health and fitness educator at the Stanford Prevention Research Center, who has served on multiple industry committees and co-authored trade books and manuals for ACE, ACSM and YMCA of the USA. She has appeared on TV worldwide and was a featured trainer on America's Next Top Model.

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