Lifelong endurance athletes had more coronary plaque, study finds

Lifelong endurance athletes in their mid-50s had more plaque in their heart arteries than men who never trained, according to the Master@Heart study flagged by Brady Holmer.

The study compared three groups of middle-aged men with an average age of about 56. There were 191 lifelong endurance athletes, 191 who started endurance training later in life, and 176 non-athletes. The lifelong athletes were 1.86 times as likely as the non-athletes to have at least one coronary plaque, meaning fatty buildup in the arteries that feed the heart.

The second number is the one cardiologists care about more. The lifelong athletes were 2.8 times as likely to have non-calcified plaque in the proximal arteries. Holmer describes that as the type and location that tend to worry cardiologists most. Calcified plaque is the stable, hardened kind. Non-calcified plaque is softer and generally considered the less reassuring finding, and proximal means it sits in the upper sections of the arteries.

There is a hopeful version of this result that the data did not support. The idea has been that if trained athletes do accumulate plaque, at least it is the stable, calcified kind, so a lifetime of hard training would buy a safer mix even if it did not buy less plaque. Holmer says that is not what showed up here.

What it actually means

Holmer does not read this as a reason to stop training, and he says so directly in the same post. His line is that athletes still tend to live longer and get cardiovascular disease less often than non-athletes. A plaque count on a scan is a marker, not an outcome, and the Master@Heart groups were compared on imaging rather than on who had heart attacks.

It is also worth being precise about who was studied. These were middle-aged men, averaging about 56, and the comparison was between decades of endurance training, a later start and no athletic background at all. That is not the same population as a 35-year-old chasing a first sub-3, and the source does not extend the finding to women or to younger runners.

Holmer's takeaway is screening rather than fear. If you have spent 30 years putting in high volume, the argument is to actually find out what is in your arteries rather than assume the training covered it, and to treat the usual risk factors as things worth measuring. He is not telling anyone to run less.

Brady Holmer

@Brady_H

X

It is concerning? Maybe. Best to know your numbers. But athletes still tend to live longer and get CVD less.

Brady Holmer

@Brady_H

X

A lifetime of training didn't come with a healthier plaque mix either.