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"Extreme" in no way endangers medieval hearts: a study

"Extreme" in no way endangers medieval hearts: a study

New studies say that medieval men participating in extreme exercises do not give their heart health.

Aging athletes doing eight or more hours a week with intense exercise do not have a higher risk of early death than people who work less often, researchers discovered.

Emergency exercises included activities such as high-speed riding or cycling, as well as sports competitions such as basketball or tennis.

In fact, middle-aged men, who had no hardening of the arteries, saw their chances of early death if they regularly engage in energetic activity, noted senior researcher Dr. Benjamin Levine. He is the director of the Institute of Gymnastics and Environmental Medicine, working with the University of Texas Southwestern Medical Center and the Texas Health Presbytery Hospital in Dallas.

"Being a high-level athlete was obviously defensive and not harmful" to those with lower arterial plaques, Levine said.

Previous studies questioned whether extreme exercise could be harmful because some very active athletes had higher coronary artery calcification levels (CAC), researchers said in a note.

Heart doctors use imaging tests to test CAC as a tool for assessing the risk of heart attack, stroke or heart disease. Coronary calcium is a footprint of atherosclerosis, in which spots accumulate in the blood vessels that provide the heart.

"Especially male athletes tended to have more coronary spots, and the plaques they had were almost all calcified," said Levin.

But no research has ever taken the next logical step, he added.

"No one has ever actually found out whether it caused them a greater risk of death or not, and that is really the whole question," Levin said. "What if they have more calcium if they don't live [prematurely]? "

In order to explore this in detail, Levine and his colleagues studied data from almost 22,000 healthy men between the ages of 40 and 80 in 1998-2013.

Men reported their activity levels and performed a coronary calcium scan. Most were runners, but some were cyclists, swimmers, swimmers or triathlists.

Extreme exercise was defined as eight or several hours a week of active activity averaging 10 metabolic equivalents, or METS, said Levine. METS is an indicator of energy consumed in an activity.

A strong exercise of 6 METS or more can include running at 6 mph or faster, cycling at 14 mph or faster, carrying heavy loads or playing competitive basketball, football or tennis, according to Harvard T.H. Chan Public Health School.

"People don't usually do it for fitness," said Levin. "They will most likely do so to be competitive."

The athletes were divided into two groups based on their CAC scores, and the researchers compared them based on their levels of physical activity. Investigators tracked the death rate of participants for any reason and especially heart disease.

During the study, highly active athletes with a low CAC score died as often as the less active men with similar CAC scores, the results revealed. They also had 61% fewer deaths from heart disease.

Those with a high CAC score also turned out to be good. Extreme athletes with high arterial calcium had about 23 percent fewer deaths compared to less active men, but there were so few deaths that the result was not statistically significant, Levine said.

"Not to say that they have a lower risk of death, we say they have no greater risk of death," Levine said about extreme athletes with high CAC scores.

The study did not include women, as their lowest death rate in middle age made statistical comparison impossible. "There seems to be a similar trend for men and women, but we can't say convincingly, because the death rate was so small" for women, Levine said.

Cardiologist Dr. Nieca Goldberg said these conclusions support the recommendations she regularly gives.

"The really important message I am trying to pass on to my patients is that you can have a plaque, but if you lead a healthy lifestyle, it helps to prevent the death of a heart attack," said Goldberg. She is the Medical Director of the New York City Health Center for Women's Health and Women's Heart Program.

However, Goldberg hesitated to say that these results would apply to women like men.

"I'd like to see a study to see what the results are," said Goldberg.

Levine pointed out that there are several possible reasons why extreme exercise can help the heart rather than harm it.

"Exercise, especially for a long time, leads to greater cardiovascular flexibility and youth," he said. "Blood vessels are better able to localize and send blood where they have to go."

It also seems that the plates in the arteries of extreme athletes tend to be calcified and more difficult, making them less exposed to tears and causing blood vessels to block, Levine said.

So how old could be too old to get involved in the extreme exercise?

"I don't think there is an upper age limit after which the benefit is falling," Levine said. "The trick is to maintain a meaningful amount of physical activity throughout your life."

Although the amount of physical exercise is not very high, you do not have to do a lot of work to keep yourself healthy, he noted.

"The biggest explosion in your buck is due to the shift from a sedentary to an active lifestyle," said Levine. "Most of the benefits of cardiovascular mortality tend to be plateau about three to five hours a week."

The study was published online on January 30th JAMA Cardiology.

Even the most suitable middle-aged athletes cannot beat cardiovascular risk factors

More information:
Benjamin Levine, M.D., Director of the Dallas Institute of Exercise and Environmental Medicine; Nieca Goldberg, M.D., Medical Director, Women's Health and Women's Heart Program Center, NYU Langone Health, New York City; January 30, 2019 JAMA Cardiology, online, DOI: 10.1001 / jamacardio.2018.4628

Harvard T.H. Chan's public health school is more than measuring physical activity.

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"Extreme" in no way endangers medieval hearts: a study (January 30, 2019)
January 30, 2019

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