Can Too Much Extreme Exercise Damage Your Heart?

Moderate exercise still best for physical, mental health

marathon runners

Exercise is good for you, but some extreme athletes can push past healthy limits.

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A research paper showed that some endurance athletes who exercised at very high intensity over long periods of time have higher rates of heart problems than people who exercise more moderately.

This new analysis of existing studies found that chronic extreme exercise training and competing in endurance events can lead to heart damage and rhythm disorders. People with genetic risk factors are especially vulnerable.

That doesn’t mean you should put away the walking shoes, though. Moderate exercise is still the best prescription for good physical and mental health – and competitive athletes shouldn’t give up their training schedule just yet.

Extreme athletes share determination, maybe risk

Unlike weekend warriors, brisk walkers or even enthusiastic joggers, extreme athletes regularly live up to their name, pushing the limits of their physical capabilities. They run 50 miles or more or repeat marathons in rapid succession, regularly pushing past exhaustion, dehydration and pain that would sideline or hospitalize many people.

All extreme athletes share a steely determination. However, this paper asks, can too much of that determination and grit hurt your heart? The analysis at the Mid America Heart Institute looked at the relative heart health of extreme athletes as compared with that of others who exercised regularly, but with less intensity and frequency.

Results of review

In addition to the Mid America study findings, research published in the European Heart Journal found evidence that elite cross country skiers increased their risk for heart arrhythmias when they skied longer and faster.

The overall findings suggest that repeated grueling workouts stress the heart muscle — not just the skeletal muscles — and that chronic damage can lead to heart troubles.

What is behind the heart risks

Extreme, long-term endurance exercise puts equally extreme demands on the cardiovascular system. Experts found that after finishing extreme running events, athletes’ blood samples contain biomarkers associated with heart damage.

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These ‘damage indicators’ usually go away by themselves, but when the heart endures extreme physical stress over and over, the “temporary” damage may lead to so called “remodeling” of the heart or physical changes such as thicker heart walls and scarring of the heart. This can also increase the risk of heart rhythm disorders, particularly for the minority who have underlying cardiac problems such as hypertrophic cardiomyopathy or coronary heart disease.

What this means for you

Dermot Phelan, MD,PhD, Director, Sports Cardiology Center at Cleveland Clinic, did not participate in the analysis, but reviewed it and states that care should be taken in interpreting these results.

“Exercise and even strenuous exercise is clearly associated with enormous heart health benefits in the vast majority of people when compared to people who do not exercise but, in a very small minority who have underlying problems, exercise can trigger arrhythmia,” he says. “While there is emerging evidence that prolonged strenuous exercise can increase risk of atrial fibrillation, the long-term risk of this is small compared to inactivity.”

Proven benefits of regular exercise include lower blood pressure, increased strength, diabetes reduction risk and better mental health.

All in all, despite the concern about extreme exercise, there is not much reason for the average person to worry, Dr. Phelan says. “Exercising is far better than being inactive.”

Exercise guidelines

Experts agree that whether you are a sports enthusiast, a beginner, a senior or someone beginning cardiac rehab, physical activity is good for you. For the general public, The American Heart Association recommends a minimum of 150 minutes of moderate physical activity per week.

Moderate exercise includes activities such as walking, jogging or swimming. In general, moderate activities should leave you free to carry on a conversation while you are active. If you have symptoms, a history of a heart condition or risk factors for heart disease, check with your doctor before starting or changing an exercise regimen.

For those who are athletes and have new symptoms or a diagnosis of heart disease, or those who may be concerned about continuing competition or endurance sports, you should be evaluated by a sports cardiologist.

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