Long-Term Marathon Running Is Associated with Low Coronary Plaque Formation in Women.

Introduction: Marathon running is presumed to improve cardiovascular risk, but health benefits of high volume running are unknown. High resolution coronary computed tomography angiography (CCTA) and a cardiac risk factor assessment were completed in women with long term marathon running histories to compare to sedentary women with similar risk factors. Methods: Women who had run at least one marathon per year for 10-25 years underwent CCTA, 12-lead ECG, blood pressure and heart rate measurement, lipid panel, and a demographic/health risk factor survey. Sedentary matched controls were derived from a contemporaneous clinical study database. CT scans were analyzed for calcified and non-calcified plaque prevalence, volume, stenosis severity, and calcium score. Results: Women marathon runners (n=26), age 42-82, with combined 1217 marathons (average 47) exhibited significantly lower coronary plaque prevalence and less calcific plaque volume. The marathon runners also had less risk factors (smoking, hypertension, and hyperlipidemia); significantly lower resting heart rate, body weight, body mass index, and triglyceride levels; and higher high-density lipoprotein cholesterol levels compared to controls (n=28). The five women runners with coronary plaque had run marathons for more years and were on average 12 years older (65 vs. 53) than the runners without plaque. Conclusion: Women marathon runners had minimal coronary artery calcium counts, lower coronary artery plaque prevalence, and less calcified plaque volume compared to sedentary women. Developing coronary artery plaque in long term women marathon runners appears related to older age and more cardiac risk factors, although the runners with coronary artery plaque had accumulated significantly more years running marathons. (C) 2016 American College of Sports Medicine

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