Young, fit athletes still carry CVD risk
Researchers found that 11% of “master” athletes had CVD, according to a study recently published in BMJ Open Sport & Exercise Medicine.
“I noticed that young, fit individuals were having heart attacks and I wanted to know why,” Barbara N. Morrison, PhD student in experimental medicine at the University of British Columbia in Canada, told Healio Family Medicine.
Researchers performed preparticipation screening on 798 master athletes who had engaged in moderate to vigorous intensity physical activity at least 3 days per week during the previous 3 months. The screening included the American Heart Association’s 14 element recommendations, an ECG and Framingham Risk Score.
Morrison noted that though using imaging tests would have been ideal, the lack of sufficient evidence justifying the tests’ use, as well as the tests’ potential risk, cost, and time commitment negated this possibility.
Of the participants, 62.7% were men and 87.7% were white. The mean age of the participants was 54.6 years. The participants had an average of 35.1 years of physical activity experience and metabolic equivalent of approximately 80.8 task hours per week.
Morrison and colleagues found that CVD was detected in 11.4%, with coronary artery disease being the most common diagnosis (7.9%). In addition, 8.5% of all participants had Framingham Risk Scores of greater than 20%, and 90% showed no CVD symptoms.
“Notably 10 participants had a blockage of 70% or greater and did not have any symptoms,” Morrison said as she discussed the results.
“While we know exercise is good for us and can prevent a range of health problems and disease, we found that middle-aged athletes are not immune to cardiovascular disease,” she added.
The findings in this study correlate with other research that has shown the number of factors that contribute to a patient’s CVD risk, according to Robert Segal, MD, of the Medical Offices of Manhattan.
“Regular exercise along with a healthy diet may delay some [CVD] events but if you have a strong genetic disposition, exercise probably will not prevent it. There is [also] a growing body of evidence showing us that nutrition, genetic, social history, stress, other diseases like diabetes, and chronic inflammation all play a vital part in increasing one’s cardiovascular risk,” he said in an interview.
Segal, who was not affiliated with Morrison and colleagues’ study, also said the findings serve as a reminder that a person’s body image is not always indicative of their health risk.
“Just because someone looks young and healthy does not mean they are. It is important to understand your patient’s family history and social history. A healthy lifestyle alone won’t always save our patients and there are plenty risk calculators one can use to assess your patient’s individual risk,” he said, noting that there are many resources and tools that a PCP can use and questions they can ask to obtain this history.
“PCPs can also make it part of their yearly exam to ask about a patient’s family history of [myocardial infarction] and stroke, check their cholesterol, and ask the patient if they have chest pain when running or shortness of breath,” Segal said.
“Any patient with an elevated cholesterol or strong family history of heart attack or stroke or diabetes, patients with elevated blood pressure, smokers and patients with symptoms of dyspnea on exertion and chest pain should probably be sent to a cardiologist for further screening,” he added. – by Janel Miller
Disclosures: Morrison reports no relevant financial disclosures. Segal is co-founder of Labfinder.com. Please see the study for all other authors’ relevant financial disclosures.