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Foulkes S, Hewitt D, Skow R, Dover D, Kaul P, La Gerche A, Haykowsky M. Outrunning the grim reaper: longevity of the first 200 sub-4 min mile male runners. Br J Sports Med 2024; 58:717-721. [PMID: 38729629 DOI: 10.1136/bjsports-2024-108386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES To determine the impact of running a sub-4 min mile on longevity. It was hypothesised that there would be an increase in longevity for runners who successfully completed a sub-4 min mile compared with the general population. METHODS As part of this retrospective cohort study, the Sub-4 Alphabetic Register was used to extract the first 200 athletes to run a sub-4 min mile. Each runner's date of birth, date of their first successful mile attempt, current age (if alive) or age at death was compared with the United Nations Life Tables to determine the difference in each runner's current age or age at death with their country of origin-specific life expectancy. RESULTS Of the first 200 sub-4 min mile runners (100% male), 60 were dead (30%) and 140 were still alive. Sub-4 min mile runners lived an average of 4.7 years beyond their predicted life expectancy (95% CI 4.7 to 4.8). When accounting for the decade of completion (1950s, 1960s or 1970s), the longevity benefits were 9.2 years (n=22; 95% CI 8.3 to 10.1), 5.5 years (n=88; 95% CI 5.3 to 5.7) and 2.9 years (n=90; 95% CI 2.7 to 3.1), respectively. CONCLUSION Sub-4 min mile runners have increased longevity compared with the general population, thereby challenging the notion that extreme endurance exercise may be detrimental to longevity.
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Affiliation(s)
- Stephen Foulkes
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Heart, Exercise and Research Trials Laboratory, St Vincent's Institute of Medical Research, Melbourne, Victoria, Australia
| | - Dean Hewitt
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel Skow
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Douglas Dover
- Canadian VIGOUR Centre, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Padma Kaul
- Canadian VIGOUR Centre, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - André La Gerche
- Heart, Exercise and Research Trials Laboratory, St Vincent's Institute of Medical Research, Melbourne, Victoria, Australia
- Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Mark Haykowsky
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Braga F, Medeiros PD, Neno AC, Meira D, Magalhães J, Emery MS. Ethnic Differences in Survival among Brazilian Modern-era Olympic Medalists from 1920 to 1992: A Cohort Study. Arq Bras Cardiol 2024; 121:e20230524. [PMID: 38597535 DOI: 10.36660/abc.20230524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/14/2023] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Disparities in health outcomes among racial groups warrant investigation, even among elite athletes. Therefore, understanding the impact of race upon post-medal survival in Brazilian Olympians becomes essential. OBJECTIVE To compare post-medal survival between white and non-white Brazilian Olympic medalists from 1920 to 1992. METHODS This study used publicly available data for a retrospective cohort study on all Brazilian Olympic medalists from 1920 to 1992 (males only). Athletes were classified into white and non-white groups using structured ethnicity determination. Kaplan-Meier analyses computed the restricted mean survival time (RMST) for each ethnic group. A Cox proportional hazards analysis assessed ethnicity-based survival differences, adjusting for medal-winning age and birth year (p<0.05). RESULTS Among 123 athletes (73.9% white), the mean age of medal achievement was 25.03±4.8 years. During the study, 18.7% of white and 37.5% of non-white athletes died (p=0.031). White athletes had a mean age at death of 75.10±18.01 years, while non-white athletes had an age of 67.13±14.90 years (p=0.109). The RMST for white athletes was 51.59 (95% CI 49.79-53.39) years, while for non-white athletes, it was 45.026 (95% CI 41.31-48.74) years, resulting in a ΔRMST of 6.56 (95% CI 2.43-10.70; p=0.0018). Multivariate analysis showed that non-white athletes had a higher mortality risk than did white athletes (HR 5.58; 95% CI, 2.18-14.31). CONCLUSION Following their first medal, white Brazilian Olympians typically enjoy a six-year longer lifespan than their non-white counterparts, illustrating a marked mortality gap and health disparities among healthy individuals in Brazil.
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Affiliation(s)
- Fabricio Braga
- Laboratório de Performance Humana, Rio de Janeiro, RJ - Brasil
- Casa de Saúde São José, Rio de Janeiro, RJ - Brasil
- Universidade do Estado do Rio de Janeiro - Faculdade de Ciências Médicas, Rio de Janeiro, RJ - Brasil
| | | | | | - Diogo Meira
- Laboratório de Performance Humana, Rio de Janeiro, RJ - Brasil
- Casa de Saúde São José, Rio de Janeiro, RJ - Brasil
| | - João Magalhães
- Laboratório de Performance Humana, Rio de Janeiro, RJ - Brasil
| | - Michael S Emery
- Cleveland Clinic - Sports Cardiology Center - Department of Cardiovascular Medicine - Heart, Vascular and Thoracic Institute, Cleveland, Ohio - EUA
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Araujo RC, Rodrigues GD, Ferreira LF, Soares PPDS. The Time Course of Cardiorespiratory Adaptations to Rowing Indoor Training in Post-Menopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3238. [PMID: 36833933 PMCID: PMC9965168 DOI: 10.3390/ijerph20043238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Post-menopausal women have impaired cardiorespiratory responses to exercise compared to young women. Exercise training may counterbalance impairments, but the time-dependent effects of exercise training remain unclear. The current study aims to investigate the effects of rowing training on maximal aerobic capacity and time-course cardiorespiratory adaptations in older women. METHODS Female participants (n = 23) were randomly allocated to the experimental group (EXP; n = 23; 66 ± 5 years old) enrolled in rowing exercise training and control group (CON; n = 10; 64 ± 4 years old). The cardiopulmonary exercise test (CET) was performed in a cycle ergometer pre- and post-interventions. Oxygen uptake (VO2), stroke volume (SV), cardiac output (CO), and HR were recorded during CET and analyzed at the peak of the exercise. HR was monitored during exercise recovery, and the index of HRR was calculated by ΔHRR (HRpeak-HR one-minute recovery). Every two weeks, Rowing Stepwise Exercise (RSE) in a rowing machine was performed to track specific adaptations to the exercise modality. HR was continuously recorded during RSE and corrected for the average power of each step (HR/watts). The rowing training protocol consisted of three weekly sessions of 30 min at an intensity corresponding to 60-80% of peak HR for ten weeks. RESULTS Rowing exercise training increased VO2, SV, and CO at the peak of the CET, and ΔHRR. Increased workload (W) and reduced HR response to a greater achieved workload (HR/W) during RSE were observed after six weeks of training. CONCLUSIONS Rowing exercise training is a feasible method to improve cardiorespiratory performance, vagal reactivation and heart rate adjustments to exercise in older women.
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Affiliation(s)
- Renata Cardoso Araujo
- Post-Graduation Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janiero 24033-900, Brazil
| | - Gabriel Dias Rodrigues
- Post-Graduation Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janiero 24033-900, Brazil
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Luana Farinazzo Ferreira
- Post-Graduation Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janiero 24033-900, Brazil
| | - Pedro Paulo da Silva Soares
- Post-Graduation Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janiero 24033-900, Brazil
- Department of Physiology and Pharmacology, Fluminense Federal University, Rio de Janiero 24210-130, Brazil
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Valenzuela PL, Baggish A, Castillo-García A, Santos-Lozano A, Boraita A, Lucia A. Strenuous Endurance Exercise and the Heart: Physiological versus Pathological Adaptations. Compr Physiol 2022; 12:4067-4085. [PMID: 35950659 DOI: 10.1002/cphy.c210045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Although the benefits of regular physical activity on cardiovascular health are well established, the effects of strenuous endurance exercise (SEE) have been a matter of debate since ancient times. In this article, we aim to provide a balanced overview of what is known about SEE and the heart-from epidemiological evidence to recent cardiac imaging findings. Lifelong SEE is overall cardioprotective, with endurance master athletes showing in fact a youthful heart. Yet, some lines of research remain open, such as the need to elucidate the time-course and potential relevance of transient declines in heart function (or increases in biomarkers of cardiac injury) with SEE. The underlying mechanisms and clinical relevance of SEE-associated atrial fibrillation, myocardial fibrosis, or high coronary artery calcium scores also remain to be elucidated. © 2022 American Physiological Society. Compr Physiol 12:1-19, 2022.
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Affiliation(s)
- Pedro L Valenzuela
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Adrián Castillo-García
- Fissac - Physiology, Health and Physical Activity, Madrid, Spain.,Biology Systems Department, University of Alcalá, Madrid, Spain
| | - Alejandro Santos-Lozano
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain.,i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain
| | - Araceli Boraita
- Department of Cardiology, Sports Medicine Center, Spanish Agency for Health Protection in Sports, Madrid, Spain
| | - Alejandro Lucia
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain.,Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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Echocardiographic Assessment of Left Ventricular Function 10 Years after the Ultra-Endurance Running Event Eco-Trail de Paris® 2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148268. [PMID: 35886119 PMCID: PMC9318254 DOI: 10.3390/ijerph19148268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/02/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022]
Abstract
Background: Regular and moderate physical activity is beneficial for physical and mental health, resulting in an increase in life expectancy for both sexes. From a cardiovascular point of view, although the benefits of regular moderate physical exercise have been established, the long-term effects of repeated ultra-endurance running events are still unknown. Hypothesis: The aim of our study is to evaluate the 10-year evolution of the parameters of the left ventricular systolic and diastolic functions of amateur subjects regularly practising ultra-endurance running events using resting echocardiography. Study design: Cross-sectional study. Level of evidence: Level 3—non-randomized controlled cohort/follow-up study. Methods: The 66 participants who participated in the 2011 edition of the Eco-Trail de Paris® were contacted by e-mail. Demographic data, sports practice, and the results of an echocardiography scan carried out during the year 2021 evaluating left ventricular systolic and diastolic function variables were collected. Echographic variables from 2011 and 2021 were compared using the paired Student’s t-test. Results: Forty-six (70%) participants responded positively. Twenty (30%) participants could not be reached and were not analysed. Of the 46 respondents, 42 (91%) provided data from a trans-thoracic cardiac ultrasound performed in 2021. Over the past 10 years, the participants reported having completed an average of 4 ± 2 ultra-trails per year. No significant differences were observed between left ventricular diastolic and systolic echocardiographic parameters between the years 2011 and 2021. Conclusions: Among amateur participants, long-distance running is not associated with an alteration in the echocardiographic parameters of resting left ventricular systolic and diastolic function after 10 years of practice. Clinical relevance: Long-term long-distance running practice is not associated with left ventricular cardiac function alteration. These results suggest a potential adaptation role of the cardiovascular system to regular and moderate long-distance running practice.
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Jouffroy R, Anglicheau D, Mansencal N, Toussaint JF, Antero J. Relationship between Exercise Intensity and IL-6 Increase during an 80 km Long-Distance Running Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116368. [PMID: 35681953 PMCID: PMC9179966 DOI: 10.3390/ijerph19116368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022]
Abstract
Background: IL-6 plasma concentration (IL-6PC) reflects the systemic inflammation related to exercise intensity level. This study aims to describe the IL-6PC kinetics during a long-distance running race. IL-6PC was measured in 20 male runners before (0 km), at each refreshment point (at 21 and 53 km, i.e., k21 and k53, respectively) and at the end of an 80 km long-distance run (k80). Methods: IL-6PC variations (absolute and relative values in each of the three sections (S)) were calculated over S1 (0_k21), S2 (k21_k53) and S3 (k53_k80) and compared with the exercise intensity (duration*race speed) within each section. Results: The mean IL-6PC increased during the run: 2.1 ± 0.6 ng.L−1 at 0 km, 21.0 ± 11.3 ng.L−1 at k21, 38.9 ± 13.0 ng.L−1 at k53 and 49.8 ± 11.9 ng.L−1 at k80. Exercise intensity increased between S1 (24.2 ± 0.5) and S2 (51.9 ± 3.2) (p = 0.04) but not between S2 and S3 (67.4 ± 4.5) (p = 0.69). IL-6PC variation was associated with exercise intensity within S1 (p = 0.03) and S2 (p = 2 × 10−3) and showed at least a trend within S3 (p = 0.06). Conclusions: IL-6PC increases that occur during the early stages of a long-distance run are associated with the running intensity, and then IL-6PC remain stable after the reduction in intensity related to the decrease in running speed.
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Affiliation(s)
- Romain Jouffroy
- Intensive Care Unit, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 92100 Boulogne-Billancourt, France
- IRMES—Institute for Research in Medicine and Epidemiology of Sport, INSEP, 75012 Paris, France; (J.F.T.); (J.A.)
- INSERM U-1018, Centre de Recherche en Epidémiologie et Santé des Populations, Paris Saclay University, 94800 Paris, France;
- URP 7329, Université de Paris, 75012 Paris, France
- Correspondence: ; Tel.: +33-0-149-095-601; Fax: +33-0-149-095-892
| | - Dany Anglicheau
- Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, 75015 Paris, France;
- Paris Descartes, Sorbonne Paris Cité University, 75006 Paris, France
- Department of Nephrology and Kidney Transplantation, Necker Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Nicolas Mansencal
- INSERM U-1018, Centre de Recherche en Epidémiologie et Santé des Populations, Paris Saclay University, 94800 Paris, France;
- Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de Référence des Cardiomyopathies et des Troubles du Rythme Cardiaque Héréditaires Ou Rares, Université de Versailles-Saint Quentin (UVSQ), 92100 Boulogne, France
| | - Jean François Toussaint
- IRMES—Institute for Research in Medicine and Epidemiology of Sport, INSEP, 75012 Paris, France; (J.F.T.); (J.A.)
- URP 7329, Université de Paris, 75012 Paris, France
- Centre d’Investigations en Médecine du Sport, Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), 75004 Paris, France
| | - Juliana Antero
- IRMES—Institute for Research in Medicine and Epidemiology of Sport, INSEP, 75012 Paris, France; (J.F.T.); (J.A.)
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De Bosscher R, Dausin C, Janssens K, Bogaert J, Elliott A, Ghekiere O, Van De Heyning CM, Sanders P, Kalman J, Fatkin D, Herbots L, Willems R, Heidbuchel H, La Gerche A, Claessen G. Rationale and design of the PROspective ATHletic Heart (Pro@Heart) study: long-term assessment of the determinants of cardiac remodelling and its clinical consequences in endurance athletes. BMJ Open Sport Exerc Med 2022; 8:e001309. [PMID: 35368514 PMCID: PMC8935177 DOI: 10.1136/bmjsem-2022-001309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 12/25/2022] Open
Abstract
Background Exercise-induced cardiac remodelling (EICR) results from the structural, functional and electrical adaptations to exercise. Despite similar sports participation, EICR varies and some athletes develop phenotypic features that overlap with cardiomyopathies. Training load and genotype may explain some of the variation; however, exercise ‘dose’ has lacked rigorous quantification. Few have investigated the association between EICR and genotype. Objectives (1) To identify the impact of training load and genotype on the variance of EICR in elite endurance athletes and (2) determine how EICR and its determinants are associated with physical performance, health benefits and cardiac pathology. Methods The Pro@Heart study is a multicentre prospective cohort trial. Three hundred elite endurance athletes aged 14–23 years will have comprehensive cardiovascular phenotyping using echocardiography, cardiac MRI, 12-lead ECG, exercise-ECG and 24-hour-Holter monitoring. Genotype will be determined using a custom cardiomyopathy gene panel and high-density single-nucleotide polymorphism arrays. Follow-up will include online tracking of training load. Cardiac phenotyping will be repeated at 2, 5, 10 and 20 years. Results The primary endpoint of the Pro@Heart study is the association of EICR with both training load and genotype. The latter will include rare variants in cardiomyopathy-associated genes and polygenic risk scores for cardiovascular traits. Secondary endpoints are the incidence of atrial and ventricular arrhythmias, physical performance and health benefits and their association with training load and genotype. Conclusion The Pro@Heart study is the first long-term cohort study to assess the impact of training load and genotype on EICR. Trial registration number NCT05164328; ACTRN12618000716268.
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Affiliation(s)
- Ruben De Bosscher
- Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | | | - Kristel Janssens
- Cardiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jan Bogaert
- Radiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Adrian Elliott
- Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Centre for Heart Rhythm Disorders, The University of Adelaide, Adelaide, South Australia, Australia
| | - Olivier Ghekiere
- Cardiology, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium.,Cardivacsular Sciences, University Hasselt Biomedical Research Institute Rehabilitation Research Center, Diepenbeek, Belgium
| | - Caroline M Van De Heyning
- Cardiology, University of Antwerp, Antwerpen, Belgium.,Cardiovascular Sciences, University Hospital Antwerp, Edegem, Belgium
| | - Prashanthan Sanders
- Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Centre for Heart Rhythm Disorders, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jonathan Kalman
- Cardiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Diane Fatkin
- Inherited Heart Diseases, Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia
| | - Lieven Herbots
- Cardiology, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium.,Cardivacsular Sciences, University Hasselt Biomedical Research Institute Rehabilitation Research Center, Diepenbeek, Belgium
| | - Rik Willems
- Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Cardiology, University Hospital Antwerp, Edegem, Belgium.,Cardiovascular Sciences, University of Antwerp, Antwerpen, Belgium
| | - André La Gerche
- Department of Cardiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Guido Claessen
- Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Cardiology, KU Leuven University Hospitals Leuven, Leuven, Belgium
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Abstract
Purpose of Review We reviewed most current medical literature in order to describe the epidemiology, clinical manifestation, outcome, and management of hypertension in athletes. Recent Findings An estimated quarter of the world’s population is suffering from hypertension and this prevalence is also reflected in athletes and in individuals involved in leisure time sport activities. Several studies found an inverse relationship between physical activity and blood pressure. Therefore, physical exercise is recommended to prevent, manage, and treat hypertension. On the other hand, the prevalence of hypertension may vary by sport and in some cases may even be higher in athletes competing in certain disciplines than in the general population. Hypertension is the most common medical condition in athletes and may raise concerns about its management and the individual’s eligibility for competitive sports. A thorough clinical evaluation should be performed to correctly diagnose or rule out hypertension in athletes, describe the individual’s risk profile, rule out secondary causes, and detect possible hypertension-mediated organ damage caused by hypertension at an early stage. Based on most recent clinical research and international consensus documents, we propose a diagnostic algorithm as well the non-pharmacological and pharmacological management of hypertension in athletes. Summary Although elevated blood pressure levels are less common in the active population, athletes are not protected from hypertension. A thorough diagnostic approach may help to identify individual at risk for adverse cardiovascular events and to address the optimal treatment as well as sport recommendations.
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Affiliation(s)
- Victor Schweiger
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Christine Attenhofer-Jost
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.,Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
| | - Stefano Caselli
- Cardiovascular Center Zurich, Hirslanden Klinik im Park, Zurich, Switzerland
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Takeuchi T, Kitamura Y, Ishizuka S, Yamada S, Aono H, Kawahara T, Sobue T. Mortality of Japanese Olympic athletes in 1964 Tokyo Olympic Games. BMJ Open Sport Exerc Med 2021; 7:e000896. [PMID: 33520254 PMCID: PMC7816928 DOI: 10.1136/bmjsem-2020-000896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2021] [Indexed: 11/06/2022] Open
Abstract
Objectives To compare the mortality of Japanese athletes in the 1964 Tokyo Olympic Games with that of the Japanese population, and to elucidate factors associated with their mortality. Methods We obtained from the Japan Sport Association study subjects’ biographical information, information on lifestyles and medical data. Missing data were obtained from online databases. Standardised mortality ratio (SMR) was calculated to compare athletes’ mortality with the Japanese population. Cox proportional hazards model was applied to estimate the HR for each category of body mass index (BMI), smoking history and handgrip strength. This analysis was limited to male athletes due to the small number of female athletes. Results Among 342 (283 men, 59 women) athletes, deaths were confirmed for 70 (64 men, 6 women) athletes between September 1964 and December 2017. Total person years was 15 974.8, and the SMR was 0.64 (95% CI 0.50 to 0.81). Multivariate analysis performed on 181 male athletes. Mortality was significantly higher for BMI≥25 kg/m2 than for 21–23 kg/m2 (HR: 3.03, 95% CI 1.01 to 9.07). We found no statistically significant associations between smoking history and mortality; the HR (95% CI) for occasional and daily smokers were 0.82 (0.26 to 2.57) and 1.30 (0.55 to 3.03) compared with never smokers. We also found no statistically significant associations between handgrip strength and mortality (P for trend: 0.51). Conclusion Japanese athletes in the 1964 Tokyo Olympic Games lived longer than the Japanese population. BMI≥25 kg/m2 was associated with higher mortality, but smoking history and handgrip strength were not associated with mortality.
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Affiliation(s)
- Taro Takeuchi
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuri Kitamura
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Soya Ishizuka
- Sport Sciences Laboratory, Japan Sport Association, Shinjuku-ku, Japan
| | - Sachiko Yamada
- Sport Sciences Laboratory, Japan Sport Association, Shinjuku-ku, Japan
| | - Hiroshi Aono
- Sport Sciences Laboratory, Japan Sport Association, Shinjuku-ku, Japan
| | - Takashi Kawahara
- Sport Medicine and Science Research Committee, Japan Sport Association, Shinjuku-ku, Japan
| | - Tomotaka Sobue
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Runacres A, Mackintosh KA, McNarry MA. Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes. Sports Med 2021; 51:289-301. [PMID: 33368029 PMCID: PMC7846545 DOI: 10.1007/s40279-020-01379-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be 'J' shaped; with elite athlete's likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes. METHODS 38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio's (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis. RESULTS Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61-0.78]; female SMR 0.51 [95% CI 0.40-0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91-1.12]). Although male athlete's CVD (SMR 0.73 [95% CI 0.62-0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63-0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86-1.40]) or END athletes cancer mortality (SMR 0.73 [0.50-1.07]). There was insufficient data to calculate female sport-specific SMR's. DISCUSSION Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the 'J' shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).
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Affiliation(s)
- Adam Runacres
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Kelly A Mackintosh
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK.
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
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Thieme L, Fröhlich M. Do Former Elite Athletes Live Longer? New Evidence From German Olympic Athletes and a First Model Description. Front Sports Act Living 2020; 2:588204. [PMID: 33345158 PMCID: PMC7739809 DOI: 10.3389/fspor.2020.588204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/05/2020] [Indexed: 12/17/2022] Open
Abstract
The positive effects of physical activity and recreational sports on health have been well-examined and are well-proven. In contrast, the consequences of extensive elite sports on life expectancy and mortality rates have been described in significantly less unique and comprehensive terms. There is a lack of models that systematically summarize the factors influencing the life span of elite athletes. Therefore, this study identifies the difference between all 6,066 German participants in Olympic Games between 1956 and 2016 and the total population, as well as between participants from the Federal Republic of Germany (FRG) and the German Democratic Republic (GDR), and between the genders. Currently, the survival rate of German Olympians is lower compared to the general population. On the contrary, it was found that Olympic success represents a linear risk for survival probability. While different types of sports do not exhibit any differences, gender and origin (FRG vs. GDR) do represent a significant risk factor. These results are combined with the current state of research to create an impact model of factors influencing the life span of elite athletes.
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Affiliation(s)
- Lutz Thieme
- University of Applied Science Koblenz, Koblenz, Germany
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Antero J, Tanaka H, De Larochelambert Q, Pohar-Perme M, Toussaint JF. Female and male US Olympic athletes live 5 years longer than their general population counterparts: a study of 8124 former US Olympians. Br J Sports Med 2020; 55:206-212. [DOI: 10.1136/bjsports-2019-101696] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 12/20/2022]
Abstract
ObjectiveTo quantify US female and male Olympic athletes’ longevity and the years of life lost or saved due to multiple causes of death as compared with the US general population.MethodsFormer US athletes who had participated in the summer or winter Olympic Games at least once between 1912 and 2012 were included. Olympians’ date of birth, death and the underlying causes of death were certified by the National Death Index. The Olympians’ overall and cause-specific mortality were compared with the US general population based on the US life tables, adjusted by sex, period and age. Mortality differences between the populations were quantified using the years lost/years saved (YS) method.Results8124 US Olympians (2301 women and 5823 men) lived 5.1 years longer (YS 95% CI 4.3 to 6.0) than the general population, based on 2309 deaths observed (225 women, 2084 men). Different causes of death contributed to longevity for Olympians as follows: 2.2 years were saved (1.9 to 2.5) from cardiovascular diseases (CVDs); cancer, 1.5 years (1.3 to 1.8); respiratory diseases (eg, influenza, pneumonia), 0.8 years (0.7 to 0.9); external causes (eg, accidents, homicides), 0.5 years (0.4 to 0.6); endocrine and metabolic diseases (eg, diabetes, hyperlipidaemia), 0.4 years (0.2 to 0.5) and digestive system diseases (eg, cirrhosis, hepatic failure), 0.3 years (0.2 to 0.4). Mortality rates due to nervous system disorders (eg, Alzheimer’s and Parkinsons’s diseases) and mental illness (eg, dementia, schizophrenia) were not different from the general population.ConclusionUS Olympians lived longer than the general population, an advantage mainly conferred by lower risks of CVD and cancer. Nervous system disorders and mental illness did not differ between US Olympians and the general population.
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The physiology of rowing with perspective on training and health. Eur J Appl Physiol 2020; 120:1943-1963. [PMID: 32627051 DOI: 10.1007/s00421-020-04429-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/27/2020] [Indexed: 01/21/2023]
Abstract
PURPOSE This review presents a perspective on the expansive literature on rowing. METHODS The PubMed database was searched for the most relevant literature, while some information was obtained from books. RESULTS Following the life span of former rowers paved the way to advocate exercise for health promotion. Rowing involves almost all muscles during the stroke and competition requires a large oxygen uptake, which is challenged by the pulmonary diffusion capacity and restriction in blood flow to the muscles. Unique training adaptations allow for simultaneous engagement of the legs in the relatively slow movement of the rowing stroke that, therefore, involves primarily slow-twitch muscle fibres. Like other sport activities, rowing is associated with adaptation not only of the heart, including both increased internal diameters and myocardial size, but also skeletal muscles with hypertrophy of especially slow-twitch muscle fibres. The high metabolic requirement of intense rowing reduces blood pH and, thereby, arterial oxygen saturation decreases as arterial oxygen tension becomes affected. CONCLUSION Competitive rowing challenges most systems in the body including pulmonary function and circulatory control with implication for cerebral blood flow and neuromuscular activation. Thus, the physiology of rowing is complex, but it obviously favours large individuals with arms and legs that allow the development of a long stroke. Present inquiries include the development of an appropriately large cardiac output despite the Valsalva-like manoeuvre associated with the stroke, and the remarkable ability of the brain to maintain motor control and metabolism despite marked reductions in cerebral blood flow and oxygenation.
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Abstract
ZusammenfassungWährend moderate sportliche Bewegung die Überlebenswahrscheinlichkeit einer Risikogruppe positiv beeinflusst, sind die Befunde im Leistungssport international gemischt. Für Deutschland liegt dazu nur eine Studie zu Fußball-Nationalspielern vor. Daher wurden mit Hilfe der Daten der Mitglieder der deutschen Olympiamannschaften 1956 bis 2016 (n = 6066) Hypothesen zu Effekten im Vergleich zur Gesamtbevölkerung, zum metabolischen Stoffwechsel, zu Einzel‑, Mix- und Mannschaftssportarten, zu Doping, zum olympischen Erfolg und zum Geschlecht getestet und dabei auch die Mitgliedschaft in den Olympiamannschaften der Bundesrepublik, der DDR sowie dem wiedervereinigten Deutschland berücksichtigt. Es zeigt sich, dass die Mitglieder der deutschen Olympiamannschaften bislang eine im Vergleich mit der Gesamtbevölkerung höhere Mortalitätsrate aufweisen, es keine höheren Überlebensraten für die Mitglieder der Olympiamannschaften der alten Bundesrepublik gibt, sich keine Differenzen zwischen Sportarten finden lassen, aber steigende olympische Erfolge zu höheren Mortalitätsraten führen.
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Kalwij A. The socio-economic status gradient in median lifespan by birth cohorts: Evidence from Dutch Olympic athletes born between 1852 and 1947. PLoS One 2019; 14:e0226269. [PMID: 31826002 PMCID: PMC6905560 DOI: 10.1371/journal.pone.0226269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 11/24/2019] [Indexed: 11/21/2022] Open
Abstract
This paper quantifies the socio-economic status (SES) gradient in median lifespan for three birth cohort groups. For this, mortality models were estimated using unique data on the SES of Dutch Olympic athletes born between 1852 and 1947, and who were followed until their death (or December 2018). The empirical findings show that for the older birth cohorts (1852–1899) there were no significant differences in median lifespan between SES groups. For the middle cohorts (1900–1919), the low SES athletes had a significantly lower median lifespan of five years less compared to medium SES athletes and the median lifespans of high and medium SES athletes did not differ significantly. For the younger cohorts (1920–1947), large and statistically significant differences were found between the three SES groups: low SES athletes had a median lifespan of about six years lower than medium SES athletes, while high SES athletes had an almost five years higher median lifespan compared to medium SES athletes. These new findings, which can be reconciled with the existing literature, suggest a strong steepening of the population SES-lifespan gradient over time in the Netherlands.
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Affiliation(s)
- Adriaan Kalwij
- Utrecht University, School of Economics, Utrecht, The Netherlands
- * E-mail:
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Gupta A, Lee MS, Gupta K, Kumar V, Reddy S. A Review of Antithrombotic Treatment in Critical Limb Ischemia After Endovascular Intervention. Cardiol Ther 2019; 8:193-209. [PMID: 31630320 PMCID: PMC6828854 DOI: 10.1007/s40119-019-00153-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Indexed: 12/14/2022] Open
Abstract
Endovascular intervention is often used to treat critical limb ischemia (CLI). Post-intervention treatment with antiplatelet and/or anticoagulant therapy has reduced morbidity and mortality due to cardiovascular complications. The purpose of this review is to shed light on the various pharmacologic treatment protocols for treating CLI following endovascular procedures. We reviewed the literature comparing outcomes after antithrombotic treatment for patients with CLI. We characterized antithrombotic therapies into three categories: (1) mono-antiplatelet therapy (MAPT) vs. dual antiplatelet therapy (DAPT), (2) MAPT vs. antiplatelet (AP) + anticoagulant (AC) therapy, and (3) AC vs. AP + AC therapy. Relevant results and statistics were extracted to determine differences in the rates of the following outcomes: (1) re-stenosis, (2) occlusion, (3) target limb revascularization (TLR), (4) major amputation, (5) major adverse cardiac events, (6) all-cause death, and (7) bleeding. Studies suggest that DAPT reduces post-surgical restenosis, TLR, and amputation for diabetic patients, without increasing major bleeding incidences, compared to MAPT. Also, AP + AC therapy provides overall superior efficacy, with no difference in bleeding incidences, compared to antiplatelet alone. Additionally, the effects were significant for restenosis, limb salvage, survival rates, and cumulative rate of above ankle amputation or death. These results suggest that treatment with DAPT and AP + AC might provide better outcomes than MAPT following the endovascular intervention for CLI, and that the ideal treatment may be related to the condition of the individual patient. However, the studies were few and heterogenous with small patient populations. Therefore, further large controlled studies are warranted to confirm these outcomes.
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Affiliation(s)
- Amol Gupta
- Heart, Vascular & Leg Center, Bakersfield, CA, USA.
| | - Michael S Lee
- Division of Cardiology, UCLA Medical Center, Los Angeles, CA, USA
| | - Kush Gupta
- Kasturba Medical College, Mangalore, India
| | - Vinod Kumar
- Heart, Vascular & Leg Center, Bakersfield, CA, USA
| | - Sarath Reddy
- Division of Cardiology, The Brooklyn Hospital Center, Brooklyn, NY, USA
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Takeuchi T, Kitamura Y, Sado J, Hattori S, Kanemura Y, Naito Y, Nakajima K, Okuwaki T, Nakata K, Kawahara T, Sobue T. Mortality of Japanese Olympic athletes: 1952-2017 cohort study. BMJ Open Sport Exerc Med 2019; 5:e000653. [PMID: 32206340 PMCID: PMC7078660 DOI: 10.1136/bmjsem-2019-000653] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2019] [Indexed: 11/15/2022] Open
Abstract
Aim To evaluate mortality among Japanese Olympic athletes compared with the general population and also evaluate their mortality based on total number of Olympics participation and intensity of sports disciplines. Methods Information on biography, vital status, date of birth, date of death and latest follow-up date on Japanese Olympians was retrieved from six online databases and compared. Standardised mortality ratio (SMR) was estimated according to observation periods and years from last participation in the Olympics. To further evaluate the association between mortality and total number of Olympics participation/intensity of sports disciplines within the study population, rate ratios (RRs) adjusted by sex, observation period and attained age group were estimated by a Poisson regression model. Results A total of 3381 Olympians were included in the analysis. The total person years was 94 076.82. The deaths of 153 (4.53%) Olympians were confirmed, and the overall SMR was 0.29 (95% CI, 0.25 to 0.34). SMRs categorised by years from last participation did not differ significantly. Higher mortality was observed among those who participated in the Olympics twice (RR: 1.52; 95% CI, 1.04 to 2.23) and three times or more (RR: 1.87; 95% CI, 1.08 to 3.25) compared with those who participated just once. Compared with combination of low static and low dynamic intensity category, higher mortality was observed in most combinations of middle-intensity or high-intensity categories. Conclusion Japanese Olympians lived longer than the general population. More frequent participation in the Olympics and higher intensity of sports disciplines were associated with higher mortality.
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Affiliation(s)
- Taro Takeuchi
- Department of Social Medicine, Osaka University, Suita, Japan
| | - Yuri Kitamura
- Department of Social Medicine, Osaka University, Suita, Japan
| | - Junya Sado
- Department of Health and Sports Sciences, Osaka University, Suita, Japan
| | - Satoshi Hattori
- Department of Integrated Medicine, Osaka University, Suita, Japan
| | - Yumiko Kanemura
- Department of Food Science and Nutrition, Mukogawa Women's University, Nishinomiya, Japan
| | - Yoshihiko Naito
- Department of Food Science and Nutrition, Mukogawa Women's University, Nishinomiya, Japan
| | - Kohei Nakajima
- Japan Institute of Sports Sciences, Kita-ku, Japan
- Japanese Olympic Committee, Tokyo, Japan
| | - Toru Okuwaki
- Japan Institute of Sports Sciences, Kita-ku, Japan
| | - Ken Nakata
- Department of Health and Sports Sciences, Osaka University, Suita, Japan
| | - Takashi Kawahara
- Japan Institute of Sports Sciences, Kita-ku, Japan
- Japanese Olympic Committee, Tokyo, Japan
| | - Tomotaka Sobue
- Department of Social Medicine, Osaka University, Suita, Japan
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Sareban M, Winkert K, Sperlich B, Berger MM, Niebauer J, Steinacker JM, Treff G. Speckle tracking-derived bi-atrial strain before and after eleven weeks of training in elite rowers. Sci Rep 2018; 8:14300. [PMID: 30250058 PMCID: PMC6155298 DOI: 10.1038/s41598-018-32542-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/10/2018] [Indexed: 11/22/2022] Open
Abstract
The left (LA) and right (RA) atria undergo adaptive remodeling in response to hemodynamic stress not only induced by endurance exercise but also as part of several cardiovascular diseases thereby confounding differential diagnosis. Echocardiographic assessment of the atria with novel speckle tracking (STE)-derived variables broadens the diagnostic spectrum compared to conventional analyses and has the potential to differentiate physiologic from pathologic changes. The purpose of this study was to assess and categorize baseline values of bi-atrial structure and function in elite rowers according to recommended cutoffs, and to assess the cardiac changes occurring with endurance training. Therefore, fifteen elite rowers underwent 2D-echocardiographic analysis of established variables of cardiac structure and function as well as STE-derived variables of bi-atrial function. Measurements were performed at baseline and after eleven weeks of extensive training. 40% of athletes displayed mildly enlarged LA and 47% mildly enlarged RA at baseline, whereas no athlete fell below the lower reference values of LA and RA reservoir strain. Average power during a 2000 m ergometer rowing test (P2000 m) improved from 426 ± 39 W to 442 ± 34 W (p = 0.010) but there were no changes of echocardiographic variables following training. In elite rowers, longitudinal bi-atrial strain assessment indicates normal resting function of structurally enlarged atria and thereby may assist to differentiate between exercise-induced versus disease-associated structural cardiac changes in which function is commonly impaired.
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Affiliation(s)
- Mahdi Sareban
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.
- Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Ulm, Germany.
| | - Kay Winkert
- Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Ulm, Germany
| | - Billy Sperlich
- Institute of Sport Science, Integrative and Experimental Exercise Science and Training, University of Würzburg, Würzburg, Germany
| | - Marc M Berger
- Department of Anesthesiology, Perioperative and General Critical Care Medicine, Salzburg General Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Ulm, Germany
| | - Gunnar Treff
- Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Ulm, Germany
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Kalwij A. The effects of competition outcomes on health: Evidence from the lifespans of U.S. Olympic medalists. ECONOMICS AND HUMAN BIOLOGY 2018; 31:276-286. [PMID: 30447409 DOI: 10.1016/j.ehb.2018.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/13/2018] [Accepted: 10/02/2018] [Indexed: 06/09/2023]
Abstract
This paper investigates the effects of competition outcomes on health by using U.S. Olympic medalists' lifespans and medal colors as a natural experiment. Whereas the life expectancies of gold and bronze medalists do not differ significantly, life expectancy of silver medalists is about 2.4 and 3.9 years less than these former, respectively. These findings are readily explainable by insights from behavioral economics, psychology, and human biology, which suggest that (perceived) dissatisfactory competition outcomes may adversely affect health. Competition outcomes that affect socioeconomic status (SES) could, therefore, play an important causal role in the positive SES-health gradient among the general population.
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Affiliation(s)
- Adriaan Kalwij
- Utrecht University School of Economics, PO Box 80125, 3508 TC Utrecht, the Netherlands.
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Antero-Jacquemin J, Pohar-Perme M, Rey G, Toussaint JF, Latouche A. The heart of the matter: years-saved from cardiovascular and cancer deaths in an elite athlete cohort with over a century of follow-up. Eur J Epidemiol 2018; 33:531-543. [PMID: 29730745 DOI: 10.1007/s10654-018-0401-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/25/2018] [Indexed: 12/21/2022]
Abstract
To quantify the years of life saved from cardiovascular (CVD), cancer and overall deaths among elite athletes according to their main type of physiological effort performed in the Olympic Games. All French athletes participating in the Games from 1912 to 2012, with vital status validated and cause of death (if concerned) identified by the national registries were included (n = 2814, 455 died) and classified according to 6 groups of effort: POWER (continuous effort < 45 s); INTERMEDIATE (45 s ≤ continuous effort < 600 s); ENDURANCE (continuous effort ≥ 600 s); POLYVALENT (participating in different events entering different classifications), INTERMITTENT (intermittent effort, i.e. team sports); PRECISION (targeting events). The theoretical years-lost method was adapted to calculate gains in longevity (years-saved) according to specific-risks under the competing risks model and was implemented in R software. Considering overall-deaths, all groups significantly saved, on average, 6.5 years of life (95% CI 5.8-7.2) compared to the general population. This longevity advantage is mainly driven by a lower risk of cancer which, isolated, contributed to significantly save 2.3 years of life (95% CI 1.2-1.9) on average in each group. The risk of CVD-related mortality in the ENDURANCE and PRECISION groups is not significantly different from the general population. The other groups significantly saved, on average, 1.6 years of life (95% CI 1.2-1.9) from CVD death. The longevity benefits in elite athletes are associated with the type of effort performed during their career, mainly due to differences on the CVD-risk of death.
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Affiliation(s)
- Juliana Antero-Jacquemin
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport, de l'Expertise et de la Performance (INSEP), 11 Avenue du Tremblay, 75012, Paris, France.
| | - Maja Pohar-Perme
- Institute of Biostastistics and Medical Informatics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Grégoire Rey
- Inserm CépiDc, Epidemiology Centre on Medical Causes of Death, Le Kremlin-Bicêtre, France
| | - Jean-François Toussaint
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport, de l'Expertise et de la Performance (INSEP), 11 Avenue du Tremblay, 75012, Paris, France.,University Paris Descartes, Sorbonne Paris Cité, Paris, France.,CIMS, Hôtel-Dieu, AP-HP, 1 Parvis Notre Dame, 75184, Paris Cedex 04, France
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Radonić V, Kozmar D, Počanić D, Jerkić H, Bohaček I, Letilović T. Mortality and causes of death among Croatian male Olympic medalists. Croat Med J 2017; 58:263-269. [PMID: 28857519 PMCID: PMC5577651 DOI: 10.3325/cmj.2017.58.263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Aim To compare the overall and disease-specific mortality of Croatian male athletes who won one or more Olympic medals representing Yugoslavia from 1948 to 1988 or Croatia from 1992 to 2016, and the general Croatian male population standardized by age and time period. Methods All 233 Croatian male Olympic medalists were included in the study. Information on life duration and cause of death for the Olympic medalists who died before January 1, 2017, was acquired from their families and acquaintances. We asked the families and acquaintances to present medical documentation for the deceased. Data about the overall and disease-specific mortality of the Croatian male population standardized by age and time period were obtained from the Croatian Bureau of Statistics (CBS). Overall and disease-specific standard mortality ratios (SMR) with 95% confidence intervals (CI) were calculated to compare the mortality rates of athletes and general population. Results Among 233 Olympic medalists, 57 died before the study endpoint. The main causes of death were cardiovascular diseases (33.3%), neoplasms (26.3%), and external causes (17.6%). The overall mortality of the Olympic medalists was significantly lower than that of general population (SMR 0.73, 95% CI 0.56-0.94, P = 0.013). Regarding specific causes of death, athletes’ mortality from cardiovascular diseases was significantly reduced (SMR 0.61, 95% CI 0.38-0.93, P = 0.021). Conclusions Croatian male Olympic medalists benefit from lower overall and cardiovascular mortality rates in comparison to the general Croatian male population.
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Affiliation(s)
- Vedran Radonić
- Vedran Radonić, Institute for Emergency Medicine Sisak and Moslavina County, Ulica 1. svibnja 20, 44000 Sisak, Croatia,
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Konopka M, Krol W, Burkhard-Jagodzinska K, Jakubiak A, Klusiewicz A, Chwalbinska J, Pokrywka A, Sitkowski D, Dluzniewski M, Braksator W. Echocardiographic assessment of right ventricle adaptation to endurance training in young rowers - speckle tracking echocardiography. Biol Sport 2017; 33:335-343. [PMID: 28090137 PMCID: PMC5143768 DOI: 10.5604/20831862.1216659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/17/2016] [Accepted: 07/01/2016] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to determine the relationship between the degree of cardiorespiratory fitness and the function of the right ventricle (RV). 117 rowers, age 17.5±1.5 years. All subjects underwent cardiopulmonary exercise. Standard echocardiography and 2D speckle tracking echocardiography with evaluation of longitudinal strain in each segment of the RV (basal - RVLS-B; mid - RVLS-M, apical - RVLS-A) and global RV free-wall strain (RVLS-G) were performed. RVLS-B values were lower compared to the RVLS-M (-25.8±4.4 vs -29.3±3.5; p<0.001) and RVLS-A values (-25.8±4.4 vs -26.2±3.4; p=0.85). Correlations between VO2max and RVLS were observed in men: RVLS-G strain (r = 0.43; p <0.001); RVLS-B (r = 0.30; p = 0.02); RVLS-M (r = 0.38; p = 0.02). A similar relationship was not observed in the group of women. The strongest predictors corresponding to a change in global and basal strain were VO2max and training time: RVLS-G (VO2max: β = 0.18, p = 0.003; training time: β = -0.39; p = 0.02) and RVLS-B (VO2max: β = 0.23; p = 0.0001 training time: β = -1.16; p = 0.0001). The global and regional reduction of RV systolic function positively correlates with the level of fitness, and this relationship is observed already in young athletes. The character of the relationship between RV deformation parameters and the variables that determine the physical performance depend on gender. The dependencies apply to the proximal fragment of the RV inflow tract, which may be a response to the type of flow during exercise in endurance athletes.
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Affiliation(s)
- M Konopka
- Department of Cardiology, Hypertension and Internal Diseases, Medical University of Warsaw, Brodno Mazovia Hospital, Street Kondratowicza 8, Warsaw, Poland
| | - W Krol
- Department of Cardiology, Hypertension and Internal Diseases, Medical University of Warsaw, Brodno Mazovia Hospital, Street Kondratowicza 8, Warsaw, Poland
| | - K Burkhard-Jagodzinska
- Institute of Sport - National Research Institute, Department of Physiology, Street Trylogii 2/16, Warsaw, Poland
| | - A Jakubiak
- Department of Cardiology, Hypertension and Internal Diseases, Medical University of Warsaw, Brodno Mazovia Hospital, Street Kondratowicza 8, Warsaw, Poland
| | - A Klusiewicz
- Institute of Sport - National Research Institute, Department of Physiology, Street Trylogii 2/16, Warsaw, Poland
| | - J Chwalbinska
- Academy of Physical Activity, Department of Sport Theory, Street Górskiego 1, Gdansk, Poland
| | - A Pokrywka
- Department of Applied and Clinical Physiology, Faculty of Medicine and Health Sciences, University of Zielona Gora, Street Zyty 28, 65-046 Zielona Góra, Poland
| | - D Sitkowski
- Institute of Sport - National Research Institute, Department of Physiology, Street Trylogii 2/16, Warsaw, Poland
| | - M Dluzniewski
- Department of Cardiology, Hypertension and Internal Diseases, Medical University of Warsaw, Brodno Mazovia Hospital, Street Kondratowicza 8, Warsaw, Poland
| | - W Braksator
- Department of Cardiology, Hypertension and Internal Diseases, Medical University of Warsaw, Brodno Mazovia Hospital, Street Kondratowicza 8, Warsaw, Poland
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Antero-Jacquemin J, Rey G, Marc A, Dor F, Haïda A, Marck A, Berthelot G, Calmat A, Latouche A, Toussaint JF. Mortality in female and male French Olympians: a 1948-2013 cohort study. Am J Sports Med 2015; 43:1505-12. [PMID: 25813868 DOI: 10.1177/0363546515574691] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Whereas intense physical activity has been associated with deleterious effects on elite athletes' health, in particular due to cardiovascular anomalies, long-term follow-ups have suggested lower mortality rates among elite athletes. Causes of death for French Olympic athletes and female elite athletes have not been studied. HYPOTHESIS/PURPOSE We aimed to measure overall and disease-specific mortality of French female and male Olympians compared with the French general population. We hypothesize that Olympians, both women and men, have lower mortality rates. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS French elite athletes (601 women and 1802 men) participating in summer or winter Olympic Games from 1948 to 2010 had their vital status verified by national sources and were followed until 2013. Causes of death were obtained via the National Death registry from 1968 to 2012. Overall and disease-specific mortalities of Olympians were compared with those of the French general population through standardized mortality ratios (SMRs) and 95% CIs. Olympians' observed and expected survivals were illustrated by Kaplan-Meier curves. RESULTS At the endpoint of the study, 13 women and 222 men had died. Overall mortality in Olympians compared with that of their compatriots was 51% lower (SMR, 0.49; 95% CI, 0.26-0.85) among women and 49% lower (SMR, 0.51; 95% CI, 0.45-0.59) among men. Olympic athletes' survival is significantly superior to that of the French general population (women, P = .03; men, P < .001). According to the total deaths occurring from 1968 to 2012 (12 among women, 202 among men), female Olympians died from neoplasm (50.0%), external causes (33.3%), and cardiovascular diseases (16.6%). The main causes of death among men were related to neoplasms (36.1%), cardiovascular diseases (24.3%), and external causes (14.4%). Regarding the main causes of mortality among male Olympic athletes, the SMRs were as follows: 0.55 for neoplasms (95% CI, 0.43-0.69), 0.55 for cardiovascular diseases (95% CI, 0.41-0.73), and 0.66 for external causes (95% CI, 0.44-0.94). CONCLUSION French Olympians live longer than their compatriots: A lower overall mortality of similar magnitude is observed among male and female athletes compared with the general population. The main causes of death in French Olympians are neoplasms, cardiovascular diseases, and external causes.
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Affiliation(s)
- Juliana Antero-Jacquemin
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France Université Paris Descartes, Paris, France
| | - Grégoire Rey
- INSERM, Centre for Epidemiology on Medical Causes of Death (CépiDc), Le Kremlin-Bicêtre, France
| | - Andy Marc
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Frédéric Dor
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Amal Haïda
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France Université de Rouen, Rouen, France
| | - Adrien Marck
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France
| | - Geoffroy Berthelot
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France Université Paris Descartes, Paris, France
| | - Alain Calmat
- Comité National Olympique Sportif Français (CNOSF), Paris, France
| | | | - Jean-François Toussaint
- Institut de Recherche bioMédicale et d'Epidémiologie du Sport (IRMES), Institut National du Sport de l'Expertise et de la Performance (INSEP), Paris, France Université Paris Descartes, Paris, France Centre d'investigations en médécine du sport (CIMS), Paris, France
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Leischik R, Dworrak B, Foshag P, Strauss M, Spelsberg N, Littwitz H, Horlitz M. Pre-participation and follow-up screening of athletes for endurance sport. J Clin Med Res 2015; 7:385-92. [PMID: 25883700 PMCID: PMC4394910 DOI: 10.14740/jocmr2129w] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 12/17/2022] Open
Abstract
Physical activity increases life expectancy and sport is a priori not harmful. Exhausted sporting activity (e.g. endurance running, triathlon, cycling or competitive sport) can lead under individual conditions to negative cardiac remodelling (pathological enlargement/function of cardiac cavities/structures) or in worst case to cardiac arrhythmias and sudden cardiac death (SCD). This individually disposition can be genetically determined or behaviourally/environmentally acquired. Overall competitive young male athletes suffer five-fold higher than non-competitive athletes from sudden death and athletes aged over 30 bear a potential for arrhythmias, atrial fibrillation or a 20-fold higher possibility for SCD as female athletes. Patients with diabetes, coronary disease, obesity or hypertension require different special managements. Screening of cardiorespiratory health for sport activities has a lot of faces. Basically there is a need for indicated examinations or possible preventive measures inside or outside of pre-competition screening. The costs of screening compared to expenditure of whole effort for sporting activities are acceptable or even negligible, but of course dependent on national/regional settings. The various causes and possibilities of screening will be discussed in this article as basic suggestion for an open discussion beyond national borders and settings.
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Affiliation(s)
- Roman Leischik
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Birgit Dworrak
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Peter Foshag
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Markus Strauss
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Norman Spelsberg
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Henning Littwitz
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
| | - Marc Horlitz
- Faculty of Health, School of Medicine, University Witten/Herdecke, Germany
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