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      Cardiovascular Risk and Disease Among Masters Endurance Athletes: Insights from the Boston MASTER (Masters Athletes Survey To Evaluate Risk) Initiative

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          Abstract

          Background

          Masters athletes (MAs), people over the age of 35 that participate in competitive sports, are a rapidly growing population that may be uniquely at risk for cardiovascular (CV) disease. The objective of this study was to develop a comprehensive clinical CV profile of MA.

          Methods

          An electronic Internet-based survey (survey response rate = 66 %) was used to characterize a community cohort of MAs residing in Eastern Massachusetts, USA. Clinical and lifestyle factors associated with prevalent CV disease were determined using logistic regression.

          Results

          Among 591 MAs (66 % men, age = 50 ± 9 years) with 21.3 ± 5.5 years of competitive endurance sport exposure, at least one CV risk factor was present in 64 % including the following: family history of premature atherosclerosis (32 %), prior/current tobacco exposure (23 %), hypertension (12.0 %), and dyslipidemia (7.4 %). There was a 9 % (54/591) prevalence of established CV disease which was accounted for largely by atrial fibrillation (AF) and coronary atherosclerosis (CAD). Prevalent AF was associated with years of exercise exposure [adjusted odds ratio, OR (95 % confidence intervals); OR = 1.10 (1.06, 1.21)] and hypertension [OR = 1.05 (1.01, 1.10)] while CAD was associated with dyslipidemia [OR = 9.09 (2.40, 34.39)] and tobacco use [OR = 1.78 (1.34, 3.10)] but was independent of exercise exposure.

          Conclusions

          Among MAs, AF is associated with prior exercise exposure whereas CAD is associated with typical risk factors including dyslipidemia and prior tobacco use. These findings suggest that there are numerous opportunities to improve disease prevention and clinical care in this population.

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          Most cited references9

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          Physical Activity and Public Health: Updated Recommendation for Adults From the American College of Sports Medicine and the American Heart Association

          In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by an expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in pertinent physiologic, epidemiologic, and clinical scientific data, including primary research articles and reviews published since the original recommendation was issued in 1995. Issues considered by the panel included new scientific evidence relating physical activity to health, physical activity recommendations by various organizations in the interim, and communications issues. Key points related to updating the physical activity recommendation were outlined and writing groups were formed. A draft manuscript was prepared and circulated for review to the expert panel as well as to outside experts. Comments were integrated into the final recommendation. To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on three days each week. [I (A)] Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30-min minimum by performing bouts each lasting 10 or more minutes. [I (B)] Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate. In addition, every adult should perform activities that maintain or increase muscular strength and endurance a minimum of two days each week. [IIa (A)] Because of the dose-response relation between physical activity and health, persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities or prevent unhealthy weight gain may benefit by exceeding the minimum recommended amounts of physical activity. [I (A)]
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            Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial.

            The increasing prevalence of obesity is a major public health concern. Physical activity may promote weight and body fat loss. To examine the effects of exercise on total and intra-abdominal body fat overall and by level of exercise. Randomized controlled trial conducted from 1997 to 2001. A total of 173 sedentary, overweight (body mass index > or =24.0 and >33% body fat), postmenopausal women aged 50 to 75 years who were living in the Seattle, Wash, area. Participants were randomly assigned to an intervention consisting of exercise facility and home-based moderate-intensity exercise (n = 87) or a stretching control group (n = 86). Changes in body weight and waist and hip circumferences at 3 and 12 months; total body, intra-abdominal, and subcutaneous abdominal fat at 12 months. Twelve-month data were available for 168 women. Women in the exercise group participated in moderate-intensity sports/recreational activity for a mean (SD) of 3.5 (1.2) d/wk for 176 (91) min/wk. Walking was the most frequently reported activity. Exercisers showed statistically significant differences from controls in baseline to 12-month changes in body weight (-1.4 kg; 95% confidence interval [CI], -2.5 to -0.3 kg), total body fat (-1.0%; 95% CI, -1.6% to -0.4%), intra-abdominal fat (-8.6 g/cm2; 95% CI, -17.8 to 0.9 g/cm2), and subcutaneous abdominal fat (-28.8 g/cm2); 95% CI, -47.5 to -10.0 g/cm2). A significant dose response for greater body fat loss was observed with increasing duration of exercise. Regular exercise such as brisk walking results in reduced body weight and body fat among overweight and obese postmenopausal women.
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              Incidence of death during jogging in Rhode Island from 1975 through 1980.

              In the six years from 1975 through 1980, a total of 12 men died during jogging in the state of Rhode Island. The cause of death in 11 was coronary heart disease (CHD). One man died of an acute gastrointestinal hemorrhage. The prevalence of jogging in the Rhode Island population was determined using a random-digit telephone survey. Among men aged 30 through 64 years, 7.4% +/- 2.6% (mean +/- SEE) reported jogging at least twice a week. The incidence of death during jogging for men of this age group was one death per year for every 7,620 joggers, or approximately one death per 396,000 man-hours of jogging. This rate is seven times the estimated death rate from CHD during more sedentary activities in Rhode Island and suggests that exercise contributes to sudden death in susceptible persons. The occurrence of only one death per 7,620 joggers per year demonstrates that the risk of exercise is small and suggests that the routine exercise testing of healthy subjects before exercise training in not justified.
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                Author and article information

                Contributors
                (617)-643-7117 , abaggish@partners.org
                Journal
                Sports Med Open
                Sports Med Open
                Sports medicine - open
                Springer International Publishing (Cham )
                2198-9761
                9 August 2016
                9 August 2016
                June 2015
                : 2
                : 29
                Affiliations
                [1 ]Tufts University School of Medicine, Boston, MA USA
                [2 ]Cardiovascular Performance Program, Massachusetts General Hospital, 55 Fruit Street, Yawkey Suite 5B, Boston, MA 02114 USA
                Article
                53
                10.1186/s40798-016-0053-0
                4978752
                33a5ef60-08fb-423a-b20f-8d0ba936caab
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 23 February 2016
                : 20 July 2016
                Categories
                Original Research Article
                Custom metadata
                © The Author(s) 2016

                exercise,masters athlete,sports cardiology,cardiovascular risk factors

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