Research

Mixed

Continuously high levels of exercise (e.g., marathon running) may have detrimental effects on cardiovascular health, including increased coronary artery calcification, suggesting a U-shaped or J-shaped dose-response curve.

For most people, moderate exercise is optimal. If you are an endurance athlete, be aware that very high volumes (like multiple marathons per year for decades) may increase coronary calcification, though this does not necessarily mean higher event rates due to potentially more stable plaques. Consult a physician if you engage in extreme endurance training.

ModerateQualifiesMEDIUM confidence
there is evidence to suggest that continuously high levels of exercise (e.g., marathon running) could have detrimental effects on cardiovascular health.
Matthew A. Nystoriak et al. · Frontiers in Cardiovascular Medicine · 2018

Why this rating

Based on observational studies and specific cohorts of endurance athletes; mechanisms are not fully elucidated.

Source

Cardiovascular Effects and Benefits of Exercise

Matthew A. Nystoriak et al. · Frontiers in Cardiovascular Medicine · 2018

DOI 10.3389/fcvm.2018.00135

narrative_reviewCited 819×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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