Can too much exercise be bad for your heart?

Can too much exercise be bad for your heart?

Exercise is often touted as beneficial for heart health, but could too much exercise actually be harmful to your heart?

Multiple studies have found that people who exercise in any amount are far less likely to experience heart problems or die from heart disease compared to people who are sedentary. Until recently, however, no past study comprehensively examined the potential for cardiovascular complications as a result of prolonged endurance exercise.

In a new study, Dr. Paul Thompson, chief of cardiology at Hartford Hospital in Connecticut and a dedicated marathon runner, examined the evidence that extreme endurance exercise may actually increase risk of cardiovascular disease and reviewed the causes and incidence of exercise-related cardiac events.

Dr. Thompson, along with his colleagues and scientists from the Netherlands, examined studies from the past 30 or more years related to exercise and heart health and dug into the findings of those studies. They found that there is no evidence that exercise is dangerous for a normal, healthy person. 

However, it is important to note that frequent training does cause “profound changes in cardiac physiology and structure,” as researchers wrote in their review. These changes can mimic heart damage, releasing proteins into the bloodstream that could indicate a heart attack. For the person exercising, however, these changes are typically short-term and the proteins usually disappear after a few days.

So what are the risks? Dr. Thompson and his colleagues found that exercise does not prevent a buildup of plaques in the arteries (a condition known as atherosclerosis) of people who are predisposed to the condition. For example, older marathon runners are just as likely to develop a buildup of dangerous plaques in the arteries as their sedentary peers. Exercising is more likely than sitting to cause the plaques to rupture, leading to a heart attack.

Another concern the new review raises is that people with a hereditary heart abnormality, such as an enlarged heart (cardiomyopathy), may increase risk of complications with strenuous exercise.

It's crucial to realize that, in the absence of strong and identified history of heart disease, there are minimal risks to exercise. In fact, for most people, exercise is crucial to help reduce the risk of a cardiovascular event. Dr. Thompson points out that the proper response to his findings is not to avoid exercise, but rather to know your family history of heart conditions and sudden death. Talk to your doctor about your family history to determine whether you need to be tested for conditions that could make strenuous exercise dangerous.

“The best evidence remains that physical activity and exercise training benefit the population, but it is possible that prolonged exercise and exercise training can adversely affect cardiac function in some individuals,” writes Dr. Thompson and his co-authors.

All people should talk with their primary care provider about heart health and get counseling on the type, intensity, frequency and duration of exercise that's best for them. Additionally, it’s important to pay attention to symptoms during exercise, such as extreme or unusual fatigue, shortness of breath or chest pain. But remember that for the majority of the population, exercise is just what is needed to strengthen the heart.

If you have a family history of heart problems or sudden death, contact a primary care provider at Goshen Health.

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