Heart attacks and lower-limb function in master endurance athletes

KUJALA, URHO M.; SARNA, SEPPO; KAPRIO, JAAKKO; KOSKENVUO, MARKKU; KARJALAINEN, JOUKO

Medicine & Science in Sports & Exercise: July 1999 - Volume 31 - Issue 7 - pp 1041-1046
Epidemiology

Heart attacks and lower-limb function in master endurance athletes. Med. Sci. Sports Exerc., Vol. 31, No. 7, pp. 1041-1046, 1999.

Purpose: Whether very vigorous physical activity bestows on the participant more health benefits or more adverse effects is unclear: we investigated whether men participating in competitive endurance sports in middle and old age are at increased risk of heart attacks as well as of lower-limb osteoarthritis and disability.

Methods: In our cohort study with an 11-yr follow-up, we studied 269 male orienteering runners (mean age 48.6 yr at baseline; range 37-61), who in 1984 were placed among the 60 best in their master orienteer age-class in Finland, and 188 male nonsmoking controls (mean age 50.4 yr; range 39-61) classified as healthy at 20 yr of age and without overt ischemic heart disease up until 1985. We followed mortality and studied the prevalence of questionnaire-reported physician-diagnosed diseases and disabilities at the end of the follow-up in late 1995.

Results: Two (0.7%) of the 269 runners and 10 (5.3%) of the 188 controls had suffered myocardial infarctions during the follow-up, the age-adjusted odds ratio (95% confidence interval) being 0.15 (0.03-0.67) in runners compared with controls (P = 0.0059). At follow-up, orienteering runners reported knee osteoarthritis and knee pain more often than did the controls, whereas the occurrence of hip osteoarthritis and hip pain did not differ. Disability due to hip or knee pain after the same everyday activities tended to be less in the runners.

Conclusion: In top-level master endurance athletes having a long-term training background and participating in competitive endurance sports, the risk both of heart attack and of lower-limb disability is low.

Unit for Sports and Exercise Medicine, Institute of Biomedicine and Department of Public Health, University of Helsinki, Helsinki, FINLAND; Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, FINLAND; Department of Public Health, University of Turku, Turku, FINLAND; and Central Military Hospital, Helsinki, FINLAND

Submitted for publication April 1998.

Accepted for publication October 1998.

This study was supported by the Finnish Ministry of Education.

Address for correspondence: Urho M. Kujala, M.D., Unit for Sports and Exercise Medicine, Institute of Biomedicine, University of Helsinki, Mannerheimintie 17 (Töölö Sports Hall), FIN-00250 Helsinki, Finland.

© 1999 Lippincott Williams & Wilkins, Inc.