New Study Explores the Impact of High-Volume Exercise on Heart Health
April 21, 2025 | Elizabeth Wingfield
Researchers from The University of Texas at Tyler School of Medicine, in collaboration with UT Southwestern Medical Center and the Kenneth H. Cooper Institute at Texas Tech University Health Sciences Center, have reported the results of a groundbreaking study examining the effects of different levels of physical activity on coronary artery disease (CAD) and overall mortality. The findings provide critical insights into the relationship between exercise quantity and heart health.
The study, published in Circulation, the flagship, peer-reviewed journal of the American Heart Association, analyzed data from more than 26,000 participants from the Cooper Center Longitudinal Study, linking exercise patterns, measures of coronary atherosclerosis by cardiac imaging, and Medicare claims data over more than 20 years. The researchers assessed the risk of heart attack and all-cause mortality across a spectrum of physical activity levels, categorized as low (less than the guideline-recommended amount), intermediate (between one and 6-times the guideline-recommended amount), and high (more than 6 times guideline-recommended amount). Current physical activity guidelines recommend 150 minutes of moderate intensity exercise (i.e. walking) or 75 minutes of vigorous intensity exercise (i.e. jogging) per week.
Key Findings:
- Individuals engaging in intermediate physical activity had the lowest risk of CAD events, such as heart attacks.
- Those performing high-volume exercise did not experience a reduction in CAD risk compared to those in the low range.
- However, individuals in the high-volume exercise group had a lower risk of all-cause mortality, reinforcing the broader health benefits of sustained physical activity beyond cardiovascular disease prevention.
- Coronary artery atherosclerosis remained a strong predictor of CAD events regardless of exercise volume. This study highlights that coronary atherosclerosis in high-volume exercisers is still associated with cardiovascular events, reinforcing the need for careful risk assessment and management in physically active populations.
Implications for Public Health and Clinical Care
This study challenges the assumption that progressively higher levels of exercise always provide additional protection against heart disease. Instead, it reinforces the importance of achieving and maintaining a balanced level of physical activity for optimal heart health. The findings also emphasize that coronary atherosclerosis should be considered a significant risk factor for coronary disease in both sedentary and highly active individuals, underscoring the importance of individualized cardiovascular risk assessment, even among those engaging in high levels of exercise.
“While high levels of physical activity are associated with overall longevity, our study suggests that more exercise does not necessarily equate to lower risk for coronary artery disease,” said lead author Dr. Jarett Berry. “Additionally, our findings demonstrate that coronary artery atherosclerosis in high-volume exercisers is clinically relevant and remains a significant marker of cardiovascular risk.”
About the Study
The research was conducted using data from the Cooper Center Longitudinal Study, a prospective cohort that tracks the long-term health effects of lifestyle behaviors in middle-aged adults. The study was supported by grants from the National Institutes of Health and conducted in collaboration with leading experts in cardiovascular medicine and epidemiology. Noor Zabad, a second-year medical student at the University of Texas at Tyler School of Medicine, played a key role in data analysis and interpretation, contributing to the study’s findings.
For more information about physical activity recommendations to support heart health, access the American Heart Association’s physical activity resources online.
With a mission to improve educational and health care outcomes for East Texas and beyond, UT Tyler offers more than 90 undergraduate and graduate programs to more than 10,000 students. Through its alignment with UT Tyler Health Science Center and UT Health East Texas, UT Tyler has unified these entities to serve Texas with quality education, cutting-edge research and excellent patient care. Classified by Carnegie as a doctoral research institution and by U.S. News & World Report as a national university, UT Tyler has campuses in Tyler, Longview, Palestine and Houston.