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As a highly active white man, you have a higher chance of atherosclerosis than black men and white men who are less active. This is the remarkable outcome of a recent study published in Mayo Clinic Proceedings.
Atherosclerosis
The insides of arteries are smooth and flexible at birth. As you age and depending on your habits, inflammation may occur, leading to thickening. In these thickened areas, or ‘plaque’, calcium deposits can also form, hence why this is also called ‘atherosclerosis’ [1]. Depending on the extent and location, this can have various adverse effects. For example, if it affects the coronary arteries, it can lead to a heart attack, where the heart is not supplied with enough blood. A stroke can occur when this happens in the blood vessels in the brain.
However, this doesn’t usually escalate to that extent. Plaque will typically not quickly grow large enough to completely block flow. Before reaching this point, plaque may rupture. When this risk exists, it’s termed ‘unstable plaque’. When unstable plaque ruptures, it leads to clot formation. These clots can rapidly increase the size of the plaque, leading to blockages.
However, this is not the usual course of events. The plaque typically will not quickly become so large as to completely block the flow. Before this point is reached, plaque can rupture. When there is a chance of this, it is called ‘unstable plaque’. When unstable plaque ruptures, it leads to clotting. These clots can cause the size of the plaque to increase rapidly, leading to blockages.
Sports and Atherosclerosis?
The researchers utilized data from 3175 men in the CARDIO study (Coronary Artery Risk Development in Young Adults). The participants were initially aged 18 to 30 and were followed for 25 years (1986 to 2011). During this period, questionnaires were completed by the participants on eight different occasions regarding their physical activity. The participants were then divided into three groups.
- Less than 150 minutes of sports per week
- 150 to 450 minutes of sports per week
- More than 450 minutes of sports per week
The researchers aimed to examine the relationship between physical activity and the risk of atherosclerosis, expecting that the most active men would have a lower risk of atherosclerosis. This plaque formation can be a significant indication of potential heart diseases. The threshold of 150 minutes was chosen because this is the American guideline for the desirable amount of exercise. To determine the calcification, a CT scan was used.
Contrary to expectations, men in group three, those who exercise the most, were found to have a 27% higher chance of plaque formation than those in group 1. Men who exercise more than the guideline (three times as much or more) thus had a higher chance of atherosclerosis than those who exercise less than the guideline.
When the influence of race was then examined, this difference was found to be mainly caused by white men. White men in group 3 were found to have a staggering 86% higher chance of atherosclerosis. Black men in the third group did not have an increased risk.
Unhealthy Exercise?
The researchers conducted this study because previous population-based cohort studies sometimes showed a relationship between the amount of physical activity and an increased risk of death. Cardiologist Dr. Jamal Rana explains that he and his colleagues attempted to explain why high activity levels in some cases actually increase the risk of death. Unique in this study is that they have been able to observe this over a period of 25 years. Among other things, it has been shown that it may be wise to examine the effects separately by race, as there may be significant differences here.
However, the researchers point out that this buildup of calcification may be of a more stable nature, reducing the risk of an attack due to rupture and clotting of the plaque. This was not investigated in this study. Although this research indicates an increased risk of atherosclerosis for very intensely exercising white men, they do not suggest that there are people who should stop exercising now.
References
- hartstichting.nl/hart-en-vaatziekten/slagaderverkalking
- Deepika R. Laddu, Jamal S. Rana, Rosenda Murillo, Michael E. Sorel, Charles P. Quesenberry, Norrina B. Allen, Kelley P. Gabriel, Mercedes R. Carnethon, Kiang Liu, Jared P. Reis, Donald Lloyd-Jones, J. Jeffrey Carr, Stephen Sidney. 25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium. Mayo Clinic Proceedings, 2017; DOI:
