Article Text
Abstract
Recent studies have found an association between high volumes of physical activity and increased levels of coronary artery calcification (CAC) among older male endurance athletes, yet the underlying mechanisms have remained largely elusive. Potential mechanisms include greater exposure to inflammatory cytokines, reactive oxygen species and oxidised low-density lipoproteins, as acute strenuous physical activity has been found to enhance their systemic release. Other possibilities include post-exercise elevations in circulating parathyroid hormone, which can modify the amount and morphology of calcific plaque, and long-term exposure to non-laminar blood flow within the coronary arteries during vigorous physical activity, particularly in individuals with pre-existing atherosclerosis. Further, although the association has only been identified in men, the role of testosterone in this process remains unclear. This brief review discusses the association between high-volume endurance exercise and CAC in older men, elaborates on the potential mechanisms underlying the increased calcification, and provides clinical implications and recommendations for those at risk.
- Coronary Artery Disease
- Computed Tomography Angiography
- Atherosclerosis
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Footnotes
Contributors All authors have contributed substantially to this manuscript and approve its submission for publication consideration. AZ—manuscript writing and figure preparation. YT—manuscript and figure editing. LLD—manuscript and figure editing. JJH—conceptual design, manuscript writing and editing, and figure preparation.
Funding This work was supported by the following grants from the National Institutes of Health/National Heart, Lung and Blood Institute (NIH/NHLBI): R01HL137647 and R01HL151391 (YT, LLD) and 1K08-HL151961 (JJH).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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