A career in sport does not eliminate risk of cardiovascular disease: A systematic review and meta-analysis of the cardiovascular health of field-based athletes

McHugh, Cliodhna; Hind, Karen; Cunningham, Joice; Davey, Daniel; Wilson, Fiona

doi:10.1016/j.jsams.2020.02.009

Cited by 13 publications

(8 citation statements)

References 63 publications

(283 reference statements)

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“…At the same time, an increase in TC, LDL, and TG, together with a progressive reduction in HDL cholesterol and a consequently higher LDL/HDL ratio, correlated with an increase in body weight and fat mass. These results agree with data reported in previous studies and findings in the general population [38].…”

Section: Discussionsupporting

confidence: 94%

Lipid Profile in Olympic Athletes: Proposal for a “Lipid Athlete Score” as a Clinical Tool to Identify High-Risk Athletes

Di Gioia,

Buzzelli,

Maestrini

et al. 2023

JCM

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Dyslipidemia is a major risk factor for atherosclerosis. Identification of dyslipidemia in athletes has raised interest in establishing preventive strategies and reducing cardiovascular (CV) events. Nowadays, targets or “scores” for athletes are undefined. The aim of our study was to create a “Lipid Athlete Score” based on lipid parameters and derive score indexes to identify high-risk athletes. We retrospectively enrolled 957 Olympic athletes practicing different sporting disciplines (power, skills, endurance, and mixed), analyzing their CV profiles and anthropometrics; 55.4% were male, the mean age was 27.1 ± 5 years, and the mean body mass index (BMI) was 23.1 ± 3.2 kg/m2. Three hundred and forty-three athletes (35.8%) were dyslipidemic (LDL ≥ 115 mg/dL or LDL/HDL ≥ 1.90). Multivariate analysis revealed the following: male p = 0.001, OR 1.88 [0.41–2.51], familiarity for dyslipidemia p = 0.001, OR 2.82 [1.72–4.59], BMI ≥ 30 kg/m2 p = 0.001, OR 2.53 [1.46–4.38], and fat mass p = 0.001, OR 2.29 [1.38–3.80] were significant. Endurance athletes presented the lowest CV risk. We proposed a lipid athlete score including major (LDL ≥ 115 mg/dL and LDL/HDL ≥ 1.90) and minor criteria (male, BMI > 30 kg/m2 or fat mass >22% for males and 32% for females, familiarity for dyslipidemia, and conventional CV risk factors). Twelve athletes (1.2%) were at high risk, 150 athletes (15.7%) at medium risk, 171 athletes (17.9%) at low risk, and 624 (65.2%) were at no risk. Dyslipidemia is very common in elite athletes. We have defined a specific lipid athlete score based on lipid parameters and derived score indexes for the stratification of risk. In accordance with this tool, a substantial proportion of athletes (16.9%) were at medium-to-high risk and need early preventive strategies to improve their lipid profiles and reduce the future development of atherosclerotic CV diseases.

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Section: Discussionsupporting

confidence: 94%

Lipid Profile in Olympic Athletes: Proposal for a “Lipid Athlete Score” as a Clinical Tool to Identify High-Risk Athletes

Di Gioia,

Buzzelli,

Maestrini

et al. 2023

JCM

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“…We found no differences in body fat percentage between the retired amateur rugby and non-contact group, although lower levels of body fat were seen in the elite rugby group compared to both groups (p=0.003, moderate effect). Higher BMI in rugby players has previously been seen with comparable levels of body fat 4 and this should also be considered in retirement given the risk for cardiometabolic disease 36 . Furthermore, in other studies of former endurance athletes, lower body fat percentage was found compared to controls 37 .…”

Section: Discussionmentioning

confidence: 85%

Lean Mass, Muscle Strength, and Muscle Quality in Retired Rugby Players: The UK Rugby Health Project

et al. 2022

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Although athletes from sports such as rugby have greater lean mass and strength during their playing careers, little is known about these characteristics post-retirement. Therefore, this study investigated lean mass, strength, and muscle quality in retired elite and amateur rugby players and non-contact athletes. Retired elite male rugby players (n=42, 43.9±10.3 y; 101.1±13.4 kg; 1.82±0.09 m), amateur rugby players (n=46, 48.0±10.5 y; 98.9±16.6 kg; 1.79±0.07 m) and non-contact athletes (n=30, 51.3±12.5 y; 91.3±13.4 kg; 1.79±0.07 m) received one total body dual-energy X-ray absorptiometry assessment of appendicular lean mass (ALM) and ALM index (ALMI). Grip strength was measured, and muscle quality (grip strength/unit of arm lean mass) was calculated. Sarcopenia was identified as ALMI<7.23 kg/m2 and handgrip strength<37.2 kg. Total lean mass, ALM and grip strength were greater in the elite rugby compared to amateur rugby and non-contact groups (p<0.01). There were no significant differences in muscle quality or sarcopenia prevalence. Retired elite rugby players had greater lean mass and grip strength than amateur rugby and non-contact athletes, although muscle quality was similar. The greater lean mass and strength might reflect genetic influences or previous participation in a highly physical sport.

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“…However, a greater risk reduction has been shown for individuals exercising 3–5 times compared with those exercising at ≥10 times 3 4. Some studies present a favourable view of longevity in elite athletes,5–8 while others suggest a higher prevalence of important cardiovascular risk factors 5 9–11. Participation in sports, such as rugby, involves more than exposure to exercise, and the concomitant impact of repetitive blunt trauma and obligated weight gain remains uncertain and sport specific 11 12.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies present a favourable view of longevity in elite athletes,5–8 while others suggest a higher prevalence of important cardiovascular risk factors 5 9–11. Participation in sports, such as rugby, involves more than exposure to exercise, and the concomitant impact of repetitive blunt trauma and obligated weight gain remains uncertain and sport specific 11 12. Prior work in rugby,13 American football14 15 and Olympic athletes5 has demonstrated a high prevalence of elevated blood pressure (BP), visceral fat and dyslipidaemia, which may relate to inflammation, a known cardiovascular risk factor.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular risk and systemic inflammation in male professional rugby: a cross-sectional study

McHugh,

Hind,

Kelly

et al. 2023

BMJ Open Sport Exerc Med

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ObjectiveTo investigate cardiovascular risk factors’ prevalence and association with systemic inflammation in professional male rugby players (RP).MethodsA cross-sectional investigation of 46 professional male RP (26.1±4.1 years) cardiovascular risk factors were compared by position. Inflammatory markers were compared with healthy controls (n=13) and patients with rheumatoid arthritis (RA) (n=10).ResultsTwenty-six per cent of RP had no risk factors, 49% had 1–2 cardiovascular risk factors and 25% had 3–4 risk factors. Forwards had greater body fat (p<0.001), visceral fat (p<0.001), glucose (p=0.025), and C reactive protein (CRP) (p=0.023) compared with backs. RP demonstrated more favourable lipid and glucose profiles than reference values for the general population. Most RP (n=28, 61%) had elevated blood pressure (≥140/90 mm Hg). RP had higher vascular adhesion molecule-1 (VCAM-1) (p=0.004) and intracellular adhesion molecule-1 (ICAM-1) (p=0.002) than healthy controls. RP had lower CRP than patients with RA (p=0.009), while one-third (n=15) displayed equivalent ICAM-1 and VCAM-1 levels. Multivariate clustering and principal component analysis biplots revealed higher triglycerides, inflammatory markers, and worse body composition were associated with forwards.ConclusionsDespite athletic status, most of this rugby cohort had at least one cardiovascular risk factor. Concomitantly, these RP demonstrated increased levels of inflammation, with one-third, primarily forwards, displaying equivalent levels to patients with inflammatory disease. Further studies are needed to unravel the prognostic implications of increased inflammation in RP because unchecked, chronic inflammation may lead to increased cardiovascular disease risk.

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A career in sport does not eliminate risk of cardiovascular disease: A systematic review and meta-analysis of the cardiovascular health of field-based athletes

Abstract: Fiona (2020) 'A career in sport does not eliminate risk of cardiovascular disease : a systematic review and meta-analysis of the cardiovascular health of eld-based athletes.', Journal of science and medicine in sport., 23 (9). pp. 792-799.

Cited by 13 publications

References 63 publications

Lipid Profile in Olympic Athletes: Proposal for a “Lipid Athlete Score” as a Clinical Tool to Identify High-Risk Athletes

Lipid Profile in Olympic Athletes: Proposal for a “Lipid Athlete Score” as a Clinical Tool to Identify High-Risk Athletes

Lean Mass, Muscle Strength, and Muscle Quality in Retired Rugby Players: The UK Rugby Health Project

Cardiovascular risk and systemic inflammation in male professional rugby: a cross-sectional study

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