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

Study Questions:

Does long-term marathon training and competition adversely affect women’s cardiovascular risk profile?


The study compared 26 women who engaged in long-term marathon running (at least 1 annually for 10-25 years) with 28 sedentary women. None of the participants had known history of cardiovascular disease. Every participant underwent coronary computed tomography angiography for characterization of plaque and electrocardiogram, serum lipid panel, height, weight, and resting blood pressure and heart rate to further characterize demographics and risk profiles. Historical lifestyle and risk factor questionnaires, including history of hyperlipidemia, hypertension, diabetes, smoking, and family history of coronary artery disease, were also completed by each participant.


The female marathon runners had significantly lower coronary artery calcium counts, lesion prevalence, and total calcified plaque volume than sedentary controls. They were leaner and smoked tobacco less. Five out of 27 female runners (14%) had asymptomatic coronary artery disease compared with 14 out of 28 sedentary women (50%). These 5 runners had fewer years running marathons and more cardiovascular risk factors than the other female runners.


Overall, running marathons annually for up to 33 years did not seem to accelerate atherosclerotic plaque formation in female runners in this study. Therefore, long-term, high-volume running does not appear to adversely affect their cardiovascular health and longevity. It is likely that plaque development in women marathon runners is related to older age and more cardiovascular risk factors, which is the case in sedentary women.


Long-term marathon training and competing (extreme endurance exercise) has been shown to increase calcified coronary plaque characteristics in male runners versus their sedentary controls. This was not the case in this study of slightly younger marathon-running women. More research is needed to explore long-term effects of extreme endurance exercise on cardiovascular health and longevity in both men and women.

Clinical Topics: Diabetes and Cardiometabolic Disease, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Prevention, Sports and Exercise Cardiology, Atherosclerotic Disease (CAD/PAD), Interventions and Coronary Artery Disease, Interventions and Imaging, Angiography, Nuclear Imaging, Exercise, Sports and Exercise and Imaging

Keywords: Coronary Angiography, Coronary Artery Disease, Electrocardiography, Exercise, Female, Longevity, Plaque, Atherosclerotic, Risk Factors, Running, Sports

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