Extreme endurance exercise may be associated with higher coronary artery calcium scores, but individuals engaging in high levels of exercise still exhibit lower rates of all-cause mortality and cardiovascular death compared to the general population.

“they showed that they stratified for every what the CAC score was maybe lower than 100 compared to CAC scores greater than 100 and then they stratified into three buckets of below 100 and above 100 and the three buckets for each so there's six total the three for each was let's say low exercise but probably more a way more exercise than the average Joe you know medium exercise and then extreme exercise which is really like at the level of probably when you were training for your having a channel and things like that and what they found was part of what I think they found to eat almost irrespective of CAC is that in terms of exercise the people who exercise the most and this is epidemiology prospective epidemiology take it with a grain of salt but the if you compared the general risk of somebody for all cause mortality or cardiovascular death or things like that they seem to have much lower rates”