How to Reduce Calcified Plaque in Athletes

Calcified plaque in the arteries is seen in some endurance athletes, especially runners. The type of plaque typically seen is dense and contains more calcium particles than those who do not exercise. If exercising is healthy, why would an endurance-type exerciser get more plaque than someone who does not exercise?

Why Calcified Plaque Develops

There are many reasons calcified plaque develops. Over 400 reasons have been elucidated, but a shorter list is more practical. The more risk factors a healthy person has, the higher the risk of developing coronary artery plaque. For example, a 55-year-old runner with a family history of coronary artery disease, moderately elevated LDL of 130, male gender, and a history of a high-stress job has more than enough risk factors to cause coronary artery disease. The additional stress of exercise increases the calcium deposits in plaque that have already occurred. There are ways that exercise impacts arterial health. Some researchers consider plaque development an adaptive response to the increased blood flow-induced shear stress through the artery during exercise.

The Impact of Exercise on Arterial Health

The ways that exercise impacts arterial health include oxidative stress from long endurance-type activities, mechanical strain on the artery wall from the foot strike, oxidative stress caused by stress hormones, and possibly increased blood pressure during exercise. Stress hormones go through a process called auto-oxidation. This is how they cause oxidative stress. It is also how chronic stress can accelerate aging, which is why people who abuse stimulants like methamphetamine, amphetamine, and cocaine age faster. This patient population has more coronary artery disease than people who do not abuse these drugs.

A competitive endurance athlete is exposed to increased stress both during training and competition. A poor diet is sometimes associated with people who exercise chronically because there is still a flawed view that exercise protects the individual and that they can eat whatever they want. This is not true.

What most of my patients ask is, “how can I stabilize this plaque or reverse it?” They want to know how they can prevent a heart attack.

Reduced Calcified Plaque and Preventing Heart Attack

Patients can work to prevent heart attacks by optimizing all biomarkers, situations, and conditions that cause plaque development. These include LDL particle number, APO B, particle size distribution, LDL level, HDL, triglycerides, average blood sugar, homocysteine, APO E, high-sensitivity CRP, PLA2, oxidized LDL, low testosterone, heavy metal exposure, chronic bacterial infections, chronic viral infections, sleep apnea, oxidative stress, poor diet, high blood pressure, and exercise-induced hypertension.

It is also important to track the plaque using carotid artery ultrasound coronary CT angiogram and/or coronary artery calcium scoring. The rate of progression is important.

Fortunately, we have enough research to draw some relatively definitive conclusions. People who exercise are still healthier and live longer than those who do not. The type of plaque athletes get is not the type that typically causes heart attacks. It is a more stable type of plaque, not the unstable type that will rupture, causing a clot in a coronary artery. Also, people with high levels of calcified plaque still have healthier heart muscle, and if they have a heart attack, they typically have much better survival rates.

As a holistic-minded cardiovascular specialist, I investigate risk factors more thoroughly and do more than prescribe statins. Diet, lifestyle stress management, identification of risk factors, and clinical nutrition are all important to reducing risk and plaque growth.  Additionally, it is essential to “test, not guess” and track plaque to prove treatment is working. Waiting until the patient has chest pain or other symptoms is not my approach.

For the most comprehensive plan available, consider my coronary artery disease program, which is a year-long program targeting risk reduction and plaque regression. Contact our office today: 303-884-7557.

 

*Aengevaeren VL, Mosterd A, Sharma S, Prakken NHJ, Möhlenkamp S, Thompson PD, Velthuis BK, Eijsvogels TMH. Exercise and Coronary Atherosclerosis: Observations, Explanations, Relevance, and Clinical Management. Circulation. 2020 Apr 21;141(16):1338-1350. doi: 10.1161/CIRCULATIONAHA.119.044467. Epub 2020 Apr 20. PMID: 32310695; PMCID: PMC7176353.