
While exercise and strength training are associated with enormous heart health benefits, there is some evidence that too much muscle can cause heart problems. Research has found that men with a higher area of abdominal muscle have a greater risk of heart trouble, while men with denser abdominal muscles had a lower risk of coronary heart disease. Additionally, chronic extreme exercise training can lead to heart damage and rhythm disorders, especially in people with underlying problems or genetic risk factors. However, it's important to note that the benefits of exercise outweigh the risks for most people, and targeted exercises to strengthen muscles can help stave off heart disease.
| Characteristics | Values |
|---|---|
| Muscle density | Higher muscle density is linked to a lower risk of coronary heart disease |
| Muscle area | Higher muscle area is linked to a higher risk of coronary heart disease |
| Intermuscular fat | High levels of intermuscular fat are linked to a higher risk of heart attack, heart failure, and death |
| Subcutaneous fat | Subcutaneous fat does not increase the risk of heart disease |
| Abdominal fat | Abdominal fat is especially hard on the heart |
| Extreme exercise | Extreme exercise can lead to heart damage and rhythm disorders, but moderate exercise is beneficial for heart health |
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What You'll Learn

Extreme exercise can damage the heart
The benefits of exercise are well-known, and physical activity is linked to a lower risk of weight gain, depression, and dementia. Exercise can also lead to increased strength, lower blood pressure, and better sleep and memory. For people with underlying problems, however, extreme exercise can trigger arrhythmia. Arrhythmia is an irregular heartbeat that can cause the heart to pump less effectively, leading to health issues.
While extreme exercise can be dangerous for some, it is important to note that the risk is small compared to inactivity. Dr Singh reassures that "all in all, despite the concern about extreme exercise, there is not much reason for the average person to worry". In fact, exercising is far better than remaining inactive.
Research has shown that muscle-building exercises can help to boost metabolic rate and burn more calories, even during rest. Strength training can be done with resistance bands, small hand weights, or weight machines. Studies suggest that strength training may boost metabolic rate by up to 15%. Additionally, muscle tissue is more metabolically active, helping to control blood sugar and lower insulin resistance, which can prevent type 2 diabetes, a major risk factor for heart disease.
While muscle mass is important for heart health, it is not just the quantity of muscle that matters but also the quality. People with high levels of intermuscular fat are at a higher risk of heart attack and heart failure. In contrast, people with higher amounts of lean muscle have a lower risk. Therefore, it is important to focus on building muscle density and quality, rather than just quantity.
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Fatty muscles increase the risk of heart disease
A study led by Professor Viviany Taqueti of Harvard Medical School found that people with pockets of fat inside their muscles are at a higher risk of heart attack, heart failure, and death. This is true regardless of their body mass index (BMI) or overall body weight. The study, which was published in the European Heart Journal, is the first to comprehensively investigate the effects of fatty muscles on heart disease.
The study found that intramuscular fat, or fatty pockets within muscle tissue, increases a person's risk of serious heart disease. Every 1% increase in fat deposited within a person's muscle fibers was associated with a 2% greater chance of having reduced blood flow to the heart and a 7% greater chance of having heart problems. These increases in risk were not affected by other known risk factors for heart disease, BMI, or subcutaneous fat.
People with high levels of intermuscular fat and evidence of coronary microvascular dysfunction (CMD) were at an especially high risk of heart problems. CMD is a condition where there is abnormal blood flow within the smallest blood vessels that supply the heart. In contrast, people with higher amounts of lean muscle had a lower risk of heart disease.
The study adds evidence that existing measures, such as BMI or waist circumference, are not adequate to evaluate the risk of heart disease accurately for all people. Professor Taqueti noted that the findings could be particularly important for understanding the heart health effects of fat and muscle-modifying therapies. However, more research is needed to understand how these findings can be used to help patients at greatest risk.
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Muscle density and quality are key
While having a lot of muscles may be aesthetically pleasing to some, it is important to consider the health implications that may arise from this. Research has shown that muscle mass and composition are predictors of cardiac health. However, this does not mean that having more muscle will automatically reduce the risk of heart problems. In fact, there is a correlation between higher muscle area and a greater risk of coronary heart disease.
The distinction between muscle area and muscle density is important. Muscle area refers to the quantity of muscle, whereas muscle density refers to the quality of muscle. Muscle density is a measure of how much fat has infiltrated the muscle cavity. Higher muscle density is associated with a lower risk of coronary heart disease. Therefore, it is important to focus on improving muscle density and quality rather than solely increasing muscle mass.
Computed tomography scans can help determine muscle density by rendering a two-dimensional image and measuring the pixel count associated with the muscle area. This allows for a more accurate assessment of muscle quality and the amount of fat infiltration. By understanding muscle density, individuals can make more informed decisions about their health and take steps to improve their muscle composition.
Exercises that target muscle strengthening can help improve muscle density and quality. Studies have shown that strength training can boost metabolic rate, increase calorie burn, and help prevent the accumulation of harmful belly fat. Additionally, muscle tissue is more metabolically active, which aids in controlling blood sugar and lowering insulin resistance, thereby reducing the risk of type 2 diabetes, a major contributor to heart disease. It is important to incorporate strength training into fitness routines, such as using resistance bands, hand weights, or weight machines.
In conclusion, while having a significant amount of muscle may be desirable for some, it is crucial to prioritize muscle density and quality over quantity. By focusing on improving muscle composition through targeted exercises and strength training, individuals can reduce their risk of heart problems and improve their overall health.
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Strength training boosts heart health
While there is some evidence that having a large muscle area can increase the risk of heart disease in men, this is not the case for everyone. In fact, strength training has been shown to improve heart health and lower the risk of premature death.
Research from the University of California San Diego found that men with a higher abdominal muscle area had a greater risk of heart trouble. However, the same study also revealed that men with greater muscle density had a lower risk of coronary heart disease.
So, it's not just about having a lot of muscle, but also about having strong, dense muscles. This is where strength training comes in. Strength training, also known as resistance training, helps to improve muscle mass and strength. It also has favourable physiological and clinical effects on cardiovascular disease and risk factors.
According to Dr Beth Frates, a clinical assistant professor at Harvard Medical School, strength training can lower the risk of high blood pressure and metabolic syndrome, both of which are risk factors for heart disease. Additionally, resistance training has been shown to have a lower rate of cardiovascular complications compared to aerobic exercise.
The American College of Sports Medicine recommends at least two non-consecutive days per week of resistance training. This can include exercises such as working out with free weights, using weight machines, resistance bands, or body-resistance exercises like push-ups, squats, and chin-ups.
While extreme endurance exercise can lead to heart damage in a small minority of people with underlying problems, moderate exercise provides enormous heart health benefits for most people. Strength training for as little as 30 to 60 minutes per week can make a significant difference in improving heart health and lowering the risk of heart-related issues.
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Abdominal fat is especially harmful
While muscle mass is generally considered beneficial for heart health, new research suggests that greater muscle area, particularly in the abdominal region, may be linked to a higher risk of coronary heart disease. This is especially true for men, as one study found that those with a larger abdominal muscle area had up to six times the risk of heart disease compared to men with smaller abdominal muscles.
However, it is important to distinguish between muscle area and muscle density. Muscle density refers to the quality of the muscle, which is determined by the amount of fat that has infiltrated the muscle cavity. Higher muscle density, indicating less fat content, is associated with a reduced risk of coronary heart disease. Therefore, it is not solely the amount of muscle that matters, but also its composition.
Abdominal fat, particularly visceral fat, is especially harmful when compared to fat in other areas of the body. This is because abdominal fat can surround internal organs, increasing the risk of several health problems, including heart disease, diabetes, liver issues, and even certain types of cancer. Additionally, abdominal fat can contribute to inflammation and altered glucose metabolism, leading to insulin resistance and metabolic syndrome. These chronic issues can further damage the blood vessels, including those supplying the heart.
The distribution of fat in the body, rather than overall weight or BMI, is a more accurate predictor of cardiovascular risk. This means that two individuals with the same BMI can have drastically different risks for heart disease, depending on their fat distribution. Thus, maintaining a healthy waist circumference is crucial for preventing heart attacks and strokes, regardless of other risk factors or treatments.
To reduce the risk associated with abdominal fat, lifestyle changes such as adopting a healthy and balanced diet, increasing physical activity, and considering weight loss strategies can be beneficial.
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Frequently asked questions
Research suggests that men with a higher area of abdominal muscle have a greater risk of heart disease. However, this is only the case when the muscle is fatty. Lean muscle is associated with a lower risk of heart disease.
The muscle/coronary connection is a term used to describe the link between muscle mass and heart health.
One theory is that the connection is caused by genetic factors. However, diet and physical activity are also suspected to play a role.
It is unclear whether there is a muscle/coronary connection in women. More research is needed.
Strength training with resistance bands, small hand weights, or weight machines can help build muscle and improve heart health.











































