New Study: Higher Cardiac Plaque Calcification in High Intensity Athletes

Carson

Sport Bacon
Team MTBNJ Halter's
See attached. I have average blood pressure and slightly elevated cholestrol (180-200) but had a CAC (calcium score) of 82, which was surprising. My doc and I expected a 0. Under 100 (but not zero) is indicative of a slightly elevated risk of heart disease. A discussion with a cardiologist revealed the latest data here, which may indicate that high intensity and endurance athletes may be more susceptible to elevated CAC. Anyways, good info for us bikers.

Summary:

Exercise intensity but not volume was associated with the progression of CAC and (mainly calcified) plaques during 6-year follow-up. Very vigorous exercise intensity (>9 METs) was associated with greater CAC and calcified plaque progression, whereas vigorous-intensity exercise (<9 METs) was associated with less CAC progression.11 A recent cross-sectional analysis from the CCLS showed that a higher weekly duration of activity was associated with more CAC, but a higher average intensity of activity was associated with less CAC in this population.12 Thus, more research is needed before final conclusions can be made regarding the impact of differences in training characteristics on coronary atherosclerosis.

 
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WOW - Great thread !! I just had my scan done last week and came back at 22 which was a bit of a surprise to me as well. I do have high blood pressure, managed with Benicar and my LDL has been slightly elevated for a few years now. I have a follow up with my primary for a review in 2 weeks.
 
FYI, anyone can get a calcium score done for $100. Just need a doc to order it. I went to ImageCare Brems Hunterdon.

@TommyF just my (barely educated) opinion that many PCPs will throw you on a statin pretty quickly, but there's some pretty serious side effects that no one seems to talk about.

Long-term use of statins, medications used to lower cholesterol levels, can potentially lead to the following side effects:
Common:
Muscle pain, tenderness, or weakness, Headache, Nausea, Diarrhea, Constipation, and Fatigue.

Less Common:

Liver damage, Increased risk of type 2 diabetes, Cataracts, Tendonitis, and Increased risk of bleeding.

Rare:

Rhabdomyolysis (severe muscle damage), Allergic reactions, Kidney damage, and Nerve damage.

Other Potential Concerns:
    • Some studies suggest that long-term statin use may increase the risk of cognitive decline or memory loss, although more research is needed.
 
following this topic. interesting.

I have not had any cardiac scans or any cardiac work done/needed. Anytime I am at the doc or urgent care its usually because I am sick. That's when I have to explain my BP and RHR are so low because I ride between 6-7K miles a year on the bike, because I get some funny looks when the nurse does the initial intake.

Im due for my annual physical I will ask my GP about this topic based on my levels of activity and see what he thinks (if anything).
 
following this topic. interesting.

I have not had any cardiac scans or any cardiac work done/needed. Anytime I am at the doc or urgent care its usually because I am sick. That's when I have to explain my BP and RHR are so low because I ride between 6-7K miles a year on the bike, because I get some funny looks when the nurse does the initial intake.

Im due for my annual physical I will ask my GP about this topic based on my levels of activity and see what he thinks (if anything).
These spooked me. Both are back to riding.

1st was late August '24. This is a long-time MASS racer who is still really fast in the really fast 60+ class.

1738179351808.png


This was about 2wks later in September. Not a racer, but a person who does ride a lot.

1738179597578.png
 
following this topic. interesting.

I have not had any cardiac scans or any cardiac work done/needed. Anytime I am at the doc or urgent care its usually because I am sick. That's when I have to explain my BP and RHR are so low because I ride between 6-7K miles a year on the bike, because I get some funny looks when the nurse does the initial intake.

Im due for my annual physical I will ask my GP about this topic based on my levels of activity and see what he thinks (if anything).

I found my PCP equates I RIDE ALOT to occasional beach cruiser rides around the block at walking pace. Our type of MTBing is not what they picture. At all. 90% of their patients don't do what we do.

This is also a relatively new study that seems to be circulating at cardiovascular conferences this year. So you may need to educate your PCP.
 
These spooked me. Both are back to riding.

1st was late August '24. This is a long-time MASS racer who is still really fast in the really fast 60+ class.

View attachment 254683

This was about 2wks later in September. Not a racer, but a person who does ride a lot.

View attachment 254684

All my idiot family smoked so much that I really have no idea on cardiac history. Three of four grandparents dead before 65 of lung cancer. The fourth is currently 100, turns 101 in May, and never smoked lol!
 
I found my PCP equates I RIDE ALOT to occasional beach cruiser rides around the block at walking pace. Our type of MTBing is not what they picture. At all. 90% of their patients don't do what we do.

This is also a relatively new study that seems to be circulating at cardiovascular conferences this year. So you may need to educate your PCP.
It's all relative. My PCP basically told me I was a lazy fuck and should ride harder trails.
 
I found my PCP equates I RIDE ALOT to occasional beach cruiser rides around the block at walking pace. Our type of MTBing is not what they picture. At all. 90% of their patients don't do what we do.
Shortly after my cancer treatments I was on medications that turned my skin into tissue paper. I was also on blood thinners due to a Pulmonary Embolism I had during treatment.

On one of my many visits to CINJ, my nurse looked at my legs and asked if I'd been attacked by a tiger. Every shrub would give me a cut. I told her I was just mountain biking, at night, since you don't want me in the sunlight. She thought I was riding a bike path. Convinced her to pull me off the blood thinners so I wouldn't bleed out during a ride.
 
Is this tested via regular blood work? Sometimes when I get bored I go the Dr with some super vague symptoms and see what they tell me I have.
 
I had the CT scan done a few years ago because I have the highest cholesterol level my doctor at the time had ever seen. She definitely said something like it would probably be $50 and insurance wouldn't cover it. Turned out it was $100. Luckily insurance doesn't cover it because somehow it'd be $2k if they did.

For $100 it's worth knowing but you can't just do a one and done, need to to do it every few years to see if the score goes up, stays steady, etc.

@Carson Thanks for the reminder I should get a CT scan.
 
This is a good topic for the aging crowd here lol I have my annual coming up, and with the heart health in my family (my dad and his brother have both had heart attacks) this will be a good discussion to have. I always thought cardiac risk was more lifestyle than genes, but its looking like they are both pretty vital.
 
I had the CT scan done a few years ago because I have the highest cholesterol level my doctor at the time had ever seen. She definitely said something like it would probably be $50 and insurance wouldn't cover it. Turned out it was $100. Luckily insurance doesn't cover it because somehow it'd be $2k if they did.

For $100 it's worth knowing but you can't just do a one and done, need to to do it every few years to see if the score goes up, stays steady, etc.

@Carson Thanks for the reminder I should get a CT scan.

I'm sure they'll get a CT scanner in NC before we land on Mars.
 
@TommyF

Update. Saw my PCP today for routine physical and she immediately, without any other info (blood work was drawn in office and pending results), suggested I should start a statin. And this was with a BP of 112/64.

I said no, and explained the concern of the side effects of statins, particularly long term side effects, and gave her the study linked above to read.

The memory loss is my big red flag as my Dad died at 74 of Alzheimers.

She firmly believed her cardiologist would advise to start a statin too, as my LDL last year was 107 and two years ago was 105. She said LDL above 70 or 80 and she recommends a statin.

My cardiologist giggled and said no. Not needed. At least not at 50 and with my activity level. Not even recommending a stress test.

I told her we'll see what my blood panel looks like but I will likely do nothing until I repeat the calcium score test in 3 years.
 
@Carson funny you mention this....

So last summer I went and had the whole run down checked on my heart....being now the same age as my dad who died of a heart attack.

Echo, calcium score, cat scan of my heart (I think thats what it was)....every test the cardiologist said there is.

Everything was perfect, calcium score was 0...my BP is better than normal, cholesterol is great....I had my Appo B checked, perfect.....Still tho, the cardiologist said...You should be on a statin because of your father. And I was like...ok, I mean im not going to argue with him persay...but to me, I didnt get it...Asked for some other opinions and they do not agree with him. So I am planning on getting another official opinion.
 
@Carson funny you mention this....

So last summer I went and had the whole run down checked on my heart....being now the same age as my dad who died of a heart attack.

Echo, calcium score, cat scan of my heart (I think thats what it was)....every test the cardiologist said there is.

Everything was perfect, calcium score was 0...my BP is better than normal, cholesterol is great....I had my Appo B checked, perfect.....Still tho, the cardiologist said...You should be on a statin because of your father. And I was like...ok, I mean im not going to argue with him persay...but to me, I didnt get it...Asked for some other opinions and they do not agree with him. So I am planning on getting another official opinion.

You gotta be your own best advocate. People tend to take the word of doctors and lawyers as gospel. I don't think every cardiologist would agree with that advice.
 
I am a firm believer that the cause of hart disease is insulin spikes. Blaming cholesterol for hart attacks is like blaming firemen for house fires. The insulin damages the insides of arteries and veins and the body uses cholesterol to prevent hemorrhages.
 
@TommyF

Update. Saw my PCP today for routine physical and she immediately, without any other info (blood work was drawn in office and pending results), suggested I should start a statin. And this was with a BP of 112/64.

I said no, and explained the concern of the side effects of statins, particularly long term side effects, and gave her the study linked above to read.

The memory loss is my big red flag as my Dad died at 74 of Alzheimers.

She firmly believed her cardiologist would advise to start a statin too, as my LDL last year was 107 and two years ago was 105. She said LDL above 70 or 80 and she recommends a statin.

My cardiologist giggled and said no. Not needed. At least not at 50 and with my activity level. Not even recommending a stress test.

I told her we'll see what my blood panel looks like but I will likely do nothing until I repeat the calcium score test in 3 years.
@Carson Appreciate the update, will post up what my PCP says on the 12th. He did give me an "A" on my physical aside from the slightly elevated LDL, everything is in the green. My boss is an ex pro baseball player who recently had a heart attack, his calcium score was very high!! I told him about this study and his eyes almost blew out of his head. I'm keeping him in the loop on all of this as well. My dad died at 60, kidney cancer, I'm 62 so I've outlived him. Dads side of the family all died fairly young, but most were alcoholics or had diabetes that they poorly managed so I don't have too much cardiac history on that side. Mom's side lives long, but there were memory issues, my mom is currently going strong at 83, she's still on the dance floor and looks dam good for her age !! Hope I've got that going for me.
 
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