Dr. Tashko’s badge from the Better Business Bureau displays an “Accredited Business” seal with an A+ rating as of July 9, 2025 for GT Health practice. The design features the BBB torch logo on the left and a clickable prompt for profile access on the right, reinforcing professional credibility, transparency, and excellence in patient care and business ethics.
🗨️ Text Us Securely

Fees | Join Our Practice

The study’s findings challenge common assumptions. While highly active middle-aged men showed a greater burden of atherosclerosis, their risk of cardiovascular disease may be lower due to the type of plaques formed. Plaques found in highly active individuals were predominantly calcified, which is important because calcified plaques are more stable. This means they are less prone to rupture and cause sudden, life-threatening events such as heart attacks. Mixed plaques, which are more likely to cause acute coronary issues, were less common in the most active group. Therefore, although these athletes had more plaques overall, the stable nature of these plaques likely contributed to better long-term heart health. This may help explain why endurance athletes often live longer despite higher levels of coronary calcification.

Dr. Tashko

For Personalized Lipid Care,
Join Dr. Tashko’s Practice!

Circulation, Observational Study, April 2017

Background: Higher levels of physical activity are associated with a lower risk of cardiovascular events. Nevertheless, there is debate on the dose-response relationship of exercise and CVD outcomes and whether high volumes of exercise may accelerate coronary atherosclerosis. We aimed to determine the relationship between lifelong exercise volumes and coronary atherosclerosis.

Methods: Middle aged men engaged in competitive or recreational leisure sports underwent a non-contrast and contrast-enhanced CT scan to assess coronary artery calcification (CAC) and plaque characteristics. Participants reported lifelong exercise history patterns. Exercise volumes were multiplied by Metabolic Equivalent of Task (MET) scores to calculate MET-min/week. Participants were categorized as <1000 MET-min/week, 1000-2000 MET-min/week or >2000 MET-min/week.

Results: 284 men (55±7 years) were included. Coronary artery calcification was present in 150/284 (53%) participants with a median CAC-score of 35.8 [9.3-145.8]. Athletes with a lifelong exercise VOLUME >2000 MET-min/week (n=75) had a significantly higher CAC-score (9.4 vs. 0, p=.02) and prevalence of coronary artery calcification (68%) and plaque (77%) compared to <1000 MET-min/week (n=88, 43% and 56% respectively).

Very vigorous intensity exercise (≥9 METs) was associated with coronary artery calcification (OR=1.47) and plaque (OR=1.56). Among participants with CAC>0, there was no difference in CAC-score (p=.20), area (p=.21), density (p=.25) and regions of interest (p=.20) across exercise volume groups.

Among participants with plaque, the most active group (>2000 MET-min/week) had a lower prevalence of MIXED plaques (48% versus 69%, OR=0.35) and more often had ONLY calcified plaques (38% versus 16%, OR=3.57) compared to the least active group (<1000 MET-min/week).

Conclusions: Participants in the >2000 MET-min/week group had a higher prevalence of coronary artery calcification and atherosclerotic plaques. The most active group did however have a more benign composition of plaques, with fewer mixed plaques and more often only calcified plaques. These observations may explain the increased longevity typical of endurance athletes despite the presence of more coronary atherosclerotic plaque in the most active participants.

Published

By

Gerti Tashko, MD
Categorized as , ,