A study published in Heart has already been posted online under the headings “Scientists find unexpected harm to physical activity” and “Physical activity may increase the risk of a heart attack.” Let's see if there is even a grain of truth in this.
What this study showed
Coronary artery calcification (deposition of calcium in the vessels supplying the heart) is currently considered an indirect sign of atherosclerosis. If a large number of calcifications are detected, doctors can prescribe prophylactic statins to prevent a heart attack.
Previously, scientists have already encountered paradoxical findings: severe calcification of the coronary arteries in physically active people. In a new study, Korean scientists tested whether it really progresses faster in people from this group than in physically inactive people.
The authors of the study followed the development of coronary artery calcification in people over 30 years of age for three years. More than 25 thousand people participated in the study. During the follow-up period, they underwent computed tomography of the heart at least twice.
Scientists found that indicators of coronary artery calcification increased faster in physically active people, especially during intense exercise (the equivalent of a daily run at least 6.5 km per day).
The researchers stressed that their work does not prove a causal relationship between physical activity and calcification. They added that it does not provide insight into whether such calcification in physically active people actually increases the risk of heart attack.
Is it better to avoid physical activity?
Scientists don't think so
The authors of the editorial in Heart pose the question differently: does the new data mean that it is time to abandon the assessment of coronary artery calcification for diagnosis? They urge doctors to interpret it with caution.
“The benefits of physical activity for the cardiovascular system are undeniable,” the authors of the study themselves write, the results of which can shake faith in physical education. In their conclusions, they point out that their findings “do not call into question the well-known benefits of physical activity for cardiovascular health.”
The evidence for the benefits of physical activity is strong
Scientists recalled that regular physical activity is associated with a variety of health benefits: reduced risk of obesity, diabetes, heart attack, stroke, risk of death and a number of other problems (1, 2, 3).
It is important to emphasize that scientific evidence indicates that the more physical activity, the better. For example, in a study that included about 130,000 people, more active people had a significantly lower risk of death, heart attacks, and strokes.
Many studies support the benefits of high-intensity exercise (1, 2, 3). However, they, as demonstrated by previous studies, may be associated with the risk of coronary artery calcification. Another study showed that this risk is increased in young people who exercise two to three times more than recommended. Scientists made similar findings in the most active older people. However, people with high physical activity but with a significant degree of coronary artery calcification had a lower risk of death than their inactive peers.
Where does this calcium come from in the arteries and what does it mean?
There are suggestions that during physical activity under the influence of various factors (stress, vascular damage, increased pressure, hormones, and others) may increase the process of deposition of cholesterol in the arteries. However, these considerations currently remain theoretical.
Second hypothesis: the described calcium deposits are not associated with an increase in cardiovascular risk. It is based on the fact that high calcium density in atherosclerotic plaques is associated with a relatively low risk of progression of atherosclerosis in the coronary arteries. Some studies suggested that atherosclerotic plaques in the vessels of athletes stop growing and stabilize.
Thus, new scientific data may have an impact on the scientific discussion around the issue of coronary artery calcification. But they are not directly related to the life of an ordinary person: physical education remains useful.