RT Journal Article
SR Electronic
T1 Assessment of cardiovascular risk and preparticipation screening protocols in masters athletes: the Masters Athlete Screening Study (MASS): a cross-sectional study
JF BMJ Open Sport & Exercise Medicine
JO BMJ OPEN SP EX MED
FD BMJ Publishing Group Ltd
SP e000370
DO 10.1136/bmjsem-2018-000370
VO 4
IS 1
A1 Barbara N Morrison
A1 James McKinney
A1 Saul Isserow
A1 Daniel Lithwick
A1 Jack Taunton
A1 Hamed Nazzari
A1 Astrid M De Souza
A1 Brett Heilbron
A1 Carlee Cater
A1 Mackenzie MacDonald
A1 Benjamin A Hives
A1 Darren E R Warburton
YR 2018
UL http://bmjopensem.bmj.com/content/4/1/e000370.abstract
AB Background Underlying coronary artery disease (CAD) is the primary cause of sudden cardiac death in masters athletes (>35 years). Preparticipation screening may detect cardiovascular disease; however, the optimal screening method is undefined in this population. The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and the American Heart Association (AHA) Preparticipation Screening Questionnaire are often currently used; however, a more comprehensive risk assessment may be required. We sought to ascertain the cardiovascular risk and to assess the effectiveness of screening tools in masters athletes.Methods This cross-sectional study performed preparticipation screening on masters athletes, which included an ECG, the AHA 14-element recommendations and Framingham Risk Score (FRS). If the preparticipation screening was abnormal, further evaluations were performed. The effectiveness of the screening tools was determined by their positive predictive value (PPV).Results 798 athletes were included in the preparticipation screening analysis (62.7% male, 54.6±9.5 years, range 35–81). The metabolic equivalent task hours per week was 80.8±44.0, and the average physical activity experience was 35.1±14.8 years. Sixty-four per cent underwent additional evaluations. Cardiovascular disease was detected in 11.4%, with CAD (7.9%) being the most common diagnosis. High FRS (>20%) was seen in 8.5% of the study population. Ten athletes were diagnosed with significant CAD; 90% were asymptomatic. A high FRS was most indicative of underlying CAD (PPV 38.2%).Conclusion Masters athletes are not immune to elevated cardiovascular risk and cardiovascular disease. Comprehensive preparticipation screening including an ECG and FRS can detect cardiovascular disease. An exercise stress test should be considered in those with risk factors, regardless of fitness level.