More Evidence on “Too Much of a Good Thing”: High Calcium Score OK for Endurance Athletes?

A recent study shows that a high calcium score, which indicates high level of calcification of coronary arteries, may be benign for endurance athletes [1]. A high calcium score was found to be more prevalent among very active men, but there was no indication of increased mortality risk. A high calcium score corresponds with increased mortality risk only in men with lower levels of physical activity. Unfortunately the study did not look at results for women.

This study was of particular interest to me because I flunked my calcium score test not long after being diagnosed with aortic stenosis. I later was cleared by two followups. In the first, I passed a stress-echo test which showed my heart beat normally under high load, which would not be the case for clogged up coronary arteries. Later, I had an angiogram which showed my arteries to be clear. I discussed all this in my article about the events leading up to my valve replacement. I’ve never got a good explanation for why I got a false alarm from the calcium score, and the literature seems to indicate that is a very accurate test with false positives being rare. But now from this latest study I know I’m a male who was averaging more than 3000 MET-minutes per week of exercise, which is the category for which a high calcium score was found to be benign.

Lead author Dr. Laura DeFina speculated that the high calcium score in heavy exercisers is associated with “denser, more stable plaque” which is why it is more benign. I learned of this on Clarence Bass’s website where there is a good discussion.

In my case, excess calcium is still a concern because calcification of replacement heart valves is a primary reason they eventually go bad. I discussed measures I take in my diet to avoid this previously. What I don’t think I mentioned there is that in the years leading up to my aortic stenosis, and my bad calcium score, I also used to take a lot of Tums for stomach acidity, which became unnecessary after I cleaned up my diet. The calcium carbonate in Tums is not well absorbed unless taken with food, which I had not been doing. Another remedy I follow is to take vitamin K2, which should help send calcium where it’s needed, like the bones, instead of to the heart.

References

1. DeFina, L, et al, “Association of All-Cause and Cardiovascular Mortality With High Levels of Physical Activity and Concurrent Coronary Artery Calcification”, JAMA Cardiol. 2019.