Skip Navigation LinksHome > January 2013 - Volume 45 - Issue 1 > Preparticipation Evaluation of Novice, Middle-Age, Long-Dist...
Medicine & Science in Sports & Exercise:
doi: 10.1249/MSS.0b013e31826c5552
Epidemiology

Preparticipation Evaluation of Novice, Middle-Age, Long-Distance Runners

AAGAARD, PHILIP1; SAHLÉN, ANDERS1; BERGFELDT, LENNART2; BRAUNSCHWEIG, FRIEDER1

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Abstract

Purpose: The purpose of this study was to assess the cardiovascular health and risk profile in middle-age men making an entry to participate for their first time in a long-distance race.

Methods: Male first-time participants, 45 yr and older, in the world’s largest cross-country running race, the Lidingöloppet, were evaluated with a medical history and physical examination, European systematic coronary risk evaluation (SCORE), 12-lead ECG, echocardiography, and blood tests. Further diagnostic workup was performed when clinically indicated.

Results: Of 265 eligible runners, 153 (58%, age 51 ± 5 yr) completed the study. Although the 10-yr fatal cardiovascular event risk was low (SCORE, 1%; interquartile range, 0%–1%), mild abnormalities were common, for example, elevated blood pressure (19%), left ventricular hypertrophy (6%), and elevated LDL cholesterol (5%). ECG changes compatible with the “athlete’s heart” were present in 82%, for example, sinus bradycardia (61%) and/or early repolarization (32%). ECG changes considered training unrelated were found in 24%, for example, prolonged QTc-interval (13%), left axis deviation (5.3%), and left atrial enlargement (4%). In 14 runners (9%), additional diagnostic workup was clinically motivated, and 4 runners (2%) were ultimately discouraged from vigorous exercise because of QTc intervals >500 ms (n = 2), symptomatic atrioventricular block (n = 1), and cardiac tumor (n = 1). The physician examination and the ECG identified 12 of the 14 participants requiring further evaluation.

Conclusions: Cardiovascular evaluation of middle-age men, including a physician examination and a 12-lead ECG, appears useful to identify individuals requiring further testing before vigorous exercise. The additional yield of routine echocardiography was small.

©2013The American College of Sports Medicine

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