Cardiovascular Considerations in Middle-Aged Athletes at Risk for Coronary Artery Disease

Abstract

Cardiovascular disease remains the leading cause of death in the United States despite a 50% decrease in deaths from myocardial infarction and stroke in the past 30 years associated with improvements in blood pressure and lipid control. The National Health and Nutrition Evaluation Survey found that the least prevalent metrics of cardiovascular health in adults were healthy diets, normal weights, and optimal levels of exercise. A further reduction in rates of cardiovascular disease will require an increase in exercise. Clinicians who encourage exercise in middle-aged patients face several dilemmas. This article reviews exercise-related risks for sudden death and the performance of a global cardiovascular risk assessment. The need for additional preexercise risk stratification with electrocardiogram, graded exercise testing, or echocardiography is outlined. In addition, the optimum choice of medications for hypertension or dyslipidemia treatment and the effects of these medications and aspirin on endurance exercise are reviewed.

Metabolic markers of heart strain in athletes (a review)

“…On the other hand, it is known that physical loads themselves may cause atherogenic changes in lipid metabolism. It is also believed that the intensity and the direction of training process determine the expressiveness of lipid metabolism changes: high physical and psychoemotional loads with mainly anaerobic character of energy supply not only fail to alter lipid metabolism in a positive way, but may even contribute to the development of early atherosclerosis in athletes and increase the risk of sudden death (Reamy, Ledford, 2013). It should be noted that chronic psychoemotional stress, related to professional activity (especially in athletes), comes with lipid spectrum changes and increase of total cholesterol level and atherogenic index, thus, indicating the role of dyslipidemias in pathogenesis of heart stress damages.…”