Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association.
Level 5 - mechanism / opinion, no new human data
American Heart Association scientific statement and expert narrative review
PubMed 32100573 · doi:10.1161/CIR.0000000000000749
What was done
The American Heart Association synthesized epidemiological and biological plausibility evidence on the cardiovascular benefits and risks of moderate-to-vigorous physical activity as well as high-volume, high-intensity exercise regimens to guide preparticipation screening and clinical counseling.
What was found
The abstract reports no numerical estimates or statistical values. It notes qualitatively that increased physical activity and fitness reduce coronary heart disease events. However, vigorous exertion increases acute risks of sudden cardiac death and myocardial infarction in susceptible or unfit individuals. High training volumes and intensities are associated with potential maladaptations—including accelerated coronary artery calcification, cardiac biomarker release, myocardial fibrosis, and atrial fibrillation—often presenting a U- or reverse J-shaped dose-response curve.
Why it matters
This statement provides clinicians with a balanced framework to contextualize rare acute cardiovascular risks and potential chronic maladaptations of extreme endurance exercise against broad public health benefits.
Limits
The abstract describes a broad expert narrative statement without reporting systematic review methodology, pooled quantitative risk estimates, or specific cohort sample sizes.
Cited by
- supports Vigorous-intensity exercise transiently increases the acute statistical risk of an adverse cardiovascular event during the exercise session itself compared to rest.