Press release: Exercising Leads to a Longer
Life, Even If You Have Plaque in Your
by Selene Yeager Jun 8 2020
People who have significant atherosclerosis (hardening
of the arteries), but are highly active have death rates
similar to those who have little or no atherosclerosis but
don’t exercise, according to a study published Mayo
Clinic Proceedings: Innovations, Quality and Outcomes.
Previous research has found ultra-endurance athletes
have higher levels of atherosclerosis than average. But
they may have more stable plaque, putting them at a
lower risk for cardiovascular disease.
Atherosclerosis—the hardening and narrowing of the arteries—
can pave the way for death and disease in the form of
arrhythmias, heart attack, stroke, chronic kidney disease, and
other health conditions.
But people with atherosclerosis who exercise regularly are no
more likely to die from any cause than people who don’t exercise
and whose arteries are free from disease, according to a study
published in Mayo Clinic Proceedings: Innovations, Quality and
Doctors screen for atherosclerosis using a test known as a
coronary artery calcium (CAC) scan, which measures the amount
of plaque build up in your arteries. CAC scores from this scan
range from 0 to >400. Generally speaking, the higher your CAC
score, the more likely you are to develop heart disease or have a
heart attack or stroke.
However, in the new study, Mount Sinai Health System
researchers found that people who exercised regularly had
significantly lower risk than their CAC scores would generally
In the study, the investigators analyzed health data from 2,318
adults between the ages of 65 and 84 who had underwent CAC
scanning between the years of 1998 and 2016. Before the scan,
the volunteers had also filled out a questionnaire that included a
line item asking them to rate how much they exercised on a 0 to
10 scale with 0 being, none and 10 being always. A score of 0 to 2
was considered low activity; 3 to 7 was moderate activity, and 8 to
10 was high exercise activity.
When researchers looked at the death rate of the participants
over a 10-year period, they found that those who reported less
physical activity had higher death rates (2.9 percent per year)
compared to those who said they were more physically active (1.7
percent per year).
What was most striking, however, is the participants who had
significant atherosclerosis (CAC scores greater than 400), but
who also reported high levels of physical activity had death rates
similar to those who had little to no atherosclerosis (CAC scores
of only 0 to 99), but also said they didn’t exercise often.
This study is even more interesting when juxtaposed with
research published in the same journal last year that reported
significantly higher rates of atherosclerosis (CAC scores great
than 100) in long time marathon and ultra distance runners
compared to those who ran shorter distances and national
“There are a number of recent studies that suggest that extreme
exercise may make some individuals more prone to developing
coronary atherosclerosis, with accompanying build up of
coronary artery calcium (CAC),” Alan Rozanski, M.D., author of
the most recent study and professor of cardiology at the Icahn
School of Medicine at Mount Sinai, told Bicycling.
“At the same time, being physically active appears to decrease an
individual’s risk for developing overt heart disease for any level of
coronary calcium build-up,” Rozanski says.
Though more research is needed to fully understand what’s going
on here, data suggests that exercise may be protective, even in the
presence of atherosclerosis, by changing the nature of the plaque,