Running to extremes: High-endurance exercise OK for heart health

Exercise is often cited as the best preventive medicine, but how much is too much for the hearts of middle-aged athletes? UT Southwestern sports cardiologist Dr. Benjamin Levine led a study, now published in JAMA Cardiology, to find the answer.


Ben Levine, M.D. Professor, Cardiology: “For the past decade or so, there’s been an increasing concern that perhaps high volume, high intensity exercise could injure the heart.”


UT Southwestern conducted a study involving almost 22,000 healthy men ages 40 – 80 who engaged in a variety of physical activity.

The goal was to determine if high levels of activity can actually be harmful to health.

Levine: “Most of the athletes in this study did predominately running, but there was a diverse group of exercise modes. Some were cyclists, some were swimmers, some were rowers, some did a combination of all three that were triathletes.”

Levine: “One area in particular that there’s been concern has been with the presence of something called coronary calcium.”

Levine: “Typically the more calcium that you have the greater risk for cardiovascular disease.”


Coronary calcium scanning provides high-resolution images of the heart.
It can illuminate plaque in the arteries.
That helps physicians better predict the risk for heart attack.

Levine: “Calcium is the footprint of atherosclerosis.

Levine: “Although athletes may have more coronary calcium, the majority of their plaques are calcified, so less likely to rupture.”

Levine: “I think we can reassure those master athletes who want to achieve those levels of physical performance for many reasons that they’re not hurting themselves.”

Levine: “The most important take home message for the exercising public is that high volumes of exercise, even in the presence of coronary calcium is safe.”