UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Cardiovascular risk in masters athletes Morrison, Barbara Nicole

Abstract

Background: Masters athletes (MAs) (>35y) are a rapidly growing population. While exercise has tremendous health benefits, there is a small absolute risk of major adverse cardiac events (MACE) in those with underlying cardiovascular disease (CVD). Prevention strategies, such as cardiovascular screening aim to identify CVD that may cause a MACE; however, they have not systematically been evaluated. Purpose: To assess cardiovascular risk in MAs and to determine the incidence, cost, and psychological implications of a screening program to detect CVD and prevent MACE in MAs. Methods: MAs underwent cardiovascular screening for five years. The screen consisted of anthropometrics, blood pressure, resting electrocardiogram, questionnaire, physical examination, and Framingham Risk Score (FRS). Participants with an abnormal screen underwent further evaluations. Impact of event scale-revised (IES-R) was used to determine the psychological impact in those diagnosed with CVD. Results: In the first year of the study, 799 MAs (63% male, 54.6 ± 9.5 years) were screened; 91 (11%) of the cohort were found to have CVD. CAD was the most common diagnosis (69.2%). During the following four years, there were an additional 89 CVD diagnoses with an incidence rate of 3.58/100, 4.14/100, 3.74/100, 1.19/100, for years two to five, respectively. A total of 10 MACE (0.30/100 athletes per year) occurred. All MACE occurred in male athletes (63.6±12.5 years). Increasing age (OR=1.05, 95%CI 1.00-1.09; p=0.038), FRS (%) (OR=1.09, 95%CI 1.03-1.16; p=0.003), and LDL cholesterol (mmol/L) (OR=1.71, 95% CI 1.22-2.40; p=0.002) were statistically significant in predicting the presence of CAD, whereas physical activity intensity and volume were not. The overall cost of the screening program was $603,465 or $3,063 per diagnosis. The initial screening year was the most expensive, yet had the highest number of diagnoses, thereby, had the lowest cost per diagnosis ($2,778). The median IES-R scores were within normal ranges. Conclusion: Yearly cardiovascular screening of MAs identified approximately 3 new diagnoses per 100 athletes per year. Despite this, MACE still occurred in MAs. In assessing MAs at risk of CAD FRS, age, and LDL-cholesterol should be utilized. Screening is justifiable, however, further research is required to refine the tools to decrease the cost.

Item Citations and Data

Rights

Attribution-NonCommercial-NoDerivatives 4.0 International