14 March 2019

Physical activity and exercise training are effective strategies to reduce the risk for cardiovascular events.

But researchers from Radboudumc, UMC Utrecht and Meander MC previously found a higher burden of coronary atherosclerosis among the most active athletes. The risks for these potential detrimental cardiac adaptations seem to be higher for runners compared to cyclists.
This was shown in a follow-up study by Vincent Aengevaeren and Thijs Eijsvogels, members of the theme Vascular damage, which was published this month in the Journal of the American College of Cardiology: Cardiovascular Imaging.
A total of 284 asymptomatic men 45 and older free from overt CVD who participated in sports either competitively or recreationally were included in this study. CT imaging was performed to determine the presence and type of coronary atherosclerosis. Cyclists had a 59% lower prevalence of atherosclerotic plaques compared with runners. Furthermore, calcified plaques, which are related to a lower risk of cardiovascular events, were more 3.5 times more common in cyclists versus runners.
These observations provide novel directions for the underlying mechanisms responsible for accelerated coronary atherosclerosis among middle-aged male athletes. For example, differences in the mode of exercise, running is weight-bearing exercise and cycling is non-weight-bearing exercise, can impact calcium homeostasis and parathyroid hormone levels, and may subsequently impact the development of coronary atherosclerosis. Furthermore, the lower exercise-intensity of cycling versus the higher exercise-intensity of runners may be another factor that could impact the amount of mechanical stress and blood pressure elevations in the coronary system.  
Aengevaeren and Eijsvogels are currently initiating the MARC-II trial (Measuring Athletes Risk of Cardiovascular Events: a follow-up study) to further explore the effects of high-volume high-intensity exercise training on coronary atherosclerosis characteristics.

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