Fit Bodies, Calcified Arteries?
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Staying active is one of the best things you can do for your heart. Regular exercise helps lower blood pressure, control blood sugar, manage weight, and reduce the risk of heart disease. But new research is raising a surprising question: Can very high levels of exercise actually lead to more calcium in the arteries—and if so, does it matter?
Let’s break it down in simple terms.
What Is Coronary Artery Calcium (CAC)?
Coronary artery calcium (CAC) refers to calcium deposits in the walls of the arteries that supply blood to your heart. These deposits are a sign of atherosclerosis, or plaque buildup, which can narrow arteries and increase the risk of heart attacks.
Doctors can measure CAC using a special heart scan. A higher CAC score usually means a higher risk of future heart problems—in most people.
But What About Very Active People?
That’s where things get interesting.
Researchers have noticed that some highly active people, like marathon runners or endurance athletes, often have higher CAC scores than less active individuals. At first, this seemed confusing. These are people who exercise regularly, eat well, and often have great blood pressure, cholesterol, and weight. So why would they have more calcium in their arteries?
A recent editorial in the journal Circulation looked at this very question. It reviewed findings from a large study of over 26,000 adults and found that:
- People who exercised a lot did tend to have more coronary calcium.
- However, this did not always translate to a higher risk of death from heart disease.
- Still, those with very high CAC scores had more heart events—like heart attacks—regardless of how active they were.
So, Is the Calcium Dangerous or Not?
It depends.
Some experts believe that in highly active people, the calcium may represent a more stable kind of plaque—less likely to break open and cause a heart attack. Others think that even in fit individuals, high CAC scores still signal some level of risk.
The truth may lie somewhere in the middle: being very active doesn’t cancel out the risks of high calcium, but it can reduce other risks and improve overall survival. In fact, the study found that total death rates were lowest in the most active group—despite higher CAC.
What Should You Do If You’re Fit but Have a High CAC Score?
If you're someone who exercises regularly and finds out you have a high CAC score, don’t panic. Here are a few practical steps to consider:
- Talk to your doctor about your overall risk. Your lifestyle, cholesterol, blood pressure, family history, and symptoms all matter.
- Manage risk factors like smoking, high blood pressure, high cholesterol, and diabetes—even if you feel great.
- Don’t stop exercising—but avoid overtraining or pushing yourself to extremes if you're not used to it.
- Know your symptoms. Learn the warning signs of heart trouble like chest pain, shortness of breath, or unusual fatigue.
- Consider medication if your doctor recommends it. Statins or other therapies may help reduce further risk.
Is More Exercise Always Better?
Moderate physical activity—like brisk walking, cycling, or swimming for 30 to 60 minutes most days—is clearly linked to better heart health. But the idea that more is always better may not be true when it comes to extreme endurance training.
This doesn’t mean people should stop being active. It means we need to understand that even the fittest bodies aren’t immune to heart disease, and that heart scans like CAC scoring can still be useful in guiding care.
Final Thoughts
Being active is still one of the best things you can do for your health. But if you’re highly active and have a high CAC score, it’s important not to ignore it. Work with your healthcare provider to make sure you’re doing everything possible to stay heart-healthy.
In the end, fitness is powerful—but so is awareness. Knowing what’s happening inside your body helps you make smarter choices—whether you’re walking your first mile or running your next marathon.