If you’ve noticed a trend in runners signing up for half-, full-, or even ultra-marathons, it isn’t just your subconscious guilting you into exercising — the number of recreational endurance exercise participants has in fact increased in recent years, and RunningUSA predicts the number of participants will continue to rise.

Research has already confirmed that moderate-intensity exercise (like walking briskly, water aerobics, or tennis) on a regular basis can improve heart health. But a recent review conducted by Massachusetts General Hospital’s Aaron L Baggish, MD, director of the Corrigan Minehan Heart Center Cardiovascular Performance Program, found that the same may not be applicable for high-intensity, strenuous exercise. His results were recently published in Current Atherosclerosis Reports.

What did the report find?

Baggish found that among endurance athletes, long-term training has been associated with early onset atrial fibrillation (an irregular heartbeat), changes in the size, shape, structure, and function of the heart, and increased coronary artery calcifications which increases risk for heart attacks and heart failure.

Additionally, data suggests that long-term participation in strenuous levels of physical activity may reduce the life-saving benefits associated with moderate-intensity exercise.

What are the implications for clinicians and patients?

The studies reviewed in this report have produced data that is worth a closer look, but Baggish says that it is too early to draw any definitive solutions. Many of the studies had too small of a sample size to provide any generalizable findings.

Based on the data available, there is no definitive evidence to support clinicians advising against high doses of exercise in healthy athletes. Clinicians who care for highly-active patients should monitor for signs of heart conditions and establish an open dialogue with patients and collaborate on decision making regarding exercise plans.

The results also shouldn’t discourage individuals from sticking to a consistent exercise routine. The American Heart Association suggests at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or a combination of moderate and vigorous activity). Visit the AHA’s website to get ideas on exercise activities.

This article has been adapted from a post on Massachusetts General Hospital’s Advances in Motion.

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