The Toll of Lifelong Endurance Exercise on the Heart

Recent studies reveal that while endurance sports like marathon running or cycling may cause arterial plaques, these are often less risky than those in inactive people.

The Toll of Lifelong Endurance Exercise on the Heart
Photo by jesse orrico / Unsplash

Does spending years cycling or running for long distances potentially damage someone’s heart?

Recent research involving athletes suggests that prolonged endurance sports like marathon running or cycling may indeed affect heart health, but not necessarily in a detrimental way. Two comprehensive studies (1,2) have examined the coronary arteries of endurance athletes and found a higher incidence of arterial plaques compared to less active individuals. However, these plaques seem to differ in composition from those in inactive people, potentially reducing the associated risks.

The studies, published in the journal Circulation, involved extensive examination of the hearts of hundreds of athletes and non-athletes. Researchers from Radboud University in the Netherlands and St. George’s University in London, among other institutions, conducted these studies. They employed advanced imaging techniques to analyze the composition of arterial plaques, which is crucial in determining their potential risk. Dense, calcified plaques are generally considered stable and less likely to cause heart attacks, unlike fatty, looser plaques.

The results showed that long-term, intense exercise is associated with arterial plaques, especially in men. The more an individual exercised, the more likely their plaques were to be calcified and dense, suggesting a potentially lower risk profile compared to the fatty plaques found in less active people.


  1. While there's a correlation between exercise and coronary calcification, the nature of these plaques in athletes appears less dangerous than in less active people
  2. The studies don't definitively conclude that exercise causes these plaques or assess the long-term health risks for athletes with plaques