Cardiac Response to Exercise in Normal Ageing: What Can We Learn from Masters Athletes?

BACKGROUND

Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing.

CONCLUSION

This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy.

Impaired vasoreactivity in bodybuilders using androgenic anabolic steroids

BACKGROUND

Anabolic androgenic steroids are used by some bodybuilders to enhance performance. While the cardiovascular implications of supraphysiological androgen levels requires further clarification, use is associated with sudden death, left ventricular hypertrophy, thrombo-embolism and cerebro-vascular events.

MATERIALS AND METHODS

To further understand the effect of androgenic anabolic steroid abuse on vascular function, this study assessed vascular stiffness (pulse-wave analysis) and cardiovascular risk factors in 28 male, bodybuilding subjects, of whom ten were actively receiving anabolic agents (group A; 26.4 +/- 7.2 years) and eight had undergone a 3-month "wash-out" period (group B; 32.1 +/- 7.1 years). The remaining ten bodybuilding subjects (group C; 24.4 +/- 4.4 years) denied any past use of anabolic steroids or other performance enhancing drugs. Comparisons were made with ten sedentary male controls (group D, 29.3 +/- 4.7 years).

RESULTS

Endothelial independent dilatation in response to glycerol trinitrate was significantly impaired in the group currently using anabolic steroids (group A) compared with the other three groups [A (5.63 +/- 3.24%) versus; B (11.10 +/- 4.91%), C (17.88 +/- 9.2%) and D (14.46 +/- 3.9%), P < 0.0005, respectively], whereas no significant differences in endothelial-dependent dilatation were detected between the groups [A (5.0 +/- 3.0%), B (7.4 +/- 3.4%), C (9.6 +/- 4.5%) and D (8.2 +/- 3.3%), P < 0.059, respectively].

CONCLUSIONS

Previous studies described a decline in vascular reactivity occurring in bodybuilding subjects which is independent of anabolic steroid use and may result from smooth muscle hypertrophy with increased vascular stiffness. This study revealed impaired vascular reactivity associated with anabolic agents and that improvement in vascular function may occur following their discontinuation.

Blood pressure and rate pressure product response in males using high-dose anabolic androgenic steroids (AAS)

The literature regarding the blood pressure response to AAS use is equivocal. In addition, there is currently little data available on the Rate Pressure Product (RPP) response to anabolic androgenic steroids (AAS) use. The experimental aim of this study was to investigate the effects of AAS administration in combination with resistance training on blood pressure and rate pressure product in male amateur bodybuilders and compare the results with a morphologically matched, resistance trained control group. Subjects were divided into two groups (n=16 AAS users; n=16 controls). Systolic and Diastolic Blood Pressure, RPP. Resting Heart Rate and Body Composition measurements were obtained before (Pre), during (During) and 6-8 weeks following (Post) the AAS cycle in the AAS users with similar time intervals for the control group. No significant cardiovascular or morphological changes in the control group were found throughout the study. Significant increases in both diastolic (P<0.01) and mean arterial blood pressures (P<0.05) were found from Pre to Post cycle in the AAS group. RPP also increased significantly (P<0.01) from pre to post AAS cycle. All cardiovascular parameters returned to normal baseline measurements between 6 and 8 weeks post cycle. No blood pressure measurements throughout the study were consistent with clinically defined hypertension. The findings indicate that the AAS group exhibited significant increases in standard cardiovascular measurements compared with the control bodybuilders, and provides a contraindication to AAS use especially in borderline hypertensives.