Elite Athletes Live Longer Than the General Population: A Meta-Analysis

Garatachea, Nuria; Santos‐Lozano, Alejandro; Sanchís-Gomar, Fabián; Fiuza‐Luces, Carmen; Pareja‐Galeano, Helios; Emanuele, Enzo; Lucía, Alejandro

doi:10.1016/j.mayocp.2014.06.004

Cited by 138 publications

(102 citation statements)

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“…In a recent metaanalysis, we reviewed 10 cohort studies to assess mortality rates in elite athletes. 32 Results showed that top-level athletes live longer than the general population and carry a lower risk of two major causes of mortality, i.e., CVD and cancer. A meta-epidemiological study by Naci and Ioannidis 33 compared the effectiveness of exercise versus drug interventions on mortality outcomes through the review of 16 meta-analyses of randomized control trials (RCTs).…”

Section: Health Policy Strategies Against Chronic Diseases: Exercisementioning

confidence: 99%

“…As we have observed, even strenuous exercise seems protective of cancer as elite athletes show a lower risk of cancer mortality. 32 Both prediagnosis and postdiagnosis exercise have been associated with reduced breast cancer-specific mortality. 115 Friedenreich and Orenstein 116 found that 32 of 44 studies analyzed revealed an average breast cancer risk reduction of 30-40% in women who were more physically active.…”

Section: Epidemiological Evidencementioning

confidence: 99%

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Exercise as a Polypill for Chronic Diseases

Pareja‐Galeano

Garatachea

Lucía

2015

Progress in Molecular Biology and Translational Science

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Section: Health Policy Strategies Against Chronic Diseases: Exercisementioning

confidence: 99%

Section: Epidemiological Evidencementioning

confidence: 99%

Exercise as a Polypill for Chronic Diseases

Pareja‐Galeano

Garatachea

Lucía

2015

Progress in Molecular Biology and Translational Science

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“…In a recent meta-analysis, we compared the standard mortality rate in former top-level athletes (n=42 807 individuals [707 women] of mixed sports disciplines, including Olympic-class marathoners or Tour de France finishers) with that of the general population. 3 The standard mortality ratio for cardiovascular disease in athletes was 0.73 (95% confidence interval, 0.65-0.82; P<0.001). These results have been severely questioned.…”

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confidence: 93%

Letter by Sanchis-Gomar et al Regarding Article, “Cardiac Remodeling in Response to 1 Year of Intensive Endurance Training”

2015

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1 sedentary people trained intensively for 12 months so that they could compete in a marathon. The left ventricle showed concentric remodeling during the first 6 to 9 months of training and thereafter dilated and restored the baseline mass-to-volume ratio. However, the right ventricle responded with a balanced remodeling, that is, eccentric hypertrophy, throughout the program, thereby maintaining a constant mass-to-volume ratio.1 Thus, contrary to conventional thinking, endurance exercise is not a primary cardiac "volume-overload" stimulus.1 This study is timely because high-intensity endurance exercise (eg, to compete in marathons or ultramarathons) is a matter of growing debate among cardiologists. Concerns about the potential association between such types of exercise and a higher risk of cardiac alterations (especially atrial fibrillation [AF] but also ventricular arrhythmias and ischemic damage) remain in the spotlight.2 Furthermore, the term cardiac overuse injury has been suggested recently to group all the possible cardiac consequences of repeated exposure to strenuous endurance exercise or "overexercise." 2 If lifelong overexercise were responsible for clinically relevant effects, one would expect this to affect the cardiovascular diseaserelated mortality in elite endurance athletes. However, epidemiological evidence does not support such a hypothesis. In a recent meta-analysis, we compared the standard mortality rate in former top-level athletes (n=42 807 individuals [707 women] of mixed sports disciplines, including Olympic-class marathoners or Tour de France finishers) with that of the general population.3 The standard mortality ratio for cardiovascular disease in athletes was 0.73 (95% confidence interval, 0.65-0.82; P<0.001). These results have been severely questioned.2 However, shortly after they were published, Kettunen and coworkers performed a hazard ratio analysis of cause-specific deaths in former Finnish male endurance, team, and power sports athletes (n=2363) and healthy control subjects (n=1657). 4 The hazard ratio for ischemic heart disease (0.68; 95% confidence interval, 0.54-0.86) and stroke mortality was lower in endurance athletes compared with control subjects (0.52; 95% confidence interval, 0.33-0.83). This is also in line with epidemiological data in >50 000 Swedes who completed a 90-km cross-country ski race and had a 57% lower rate of cardiovascular disease. 5 We are aware of the potential risk of AF among endurance athletes (at a younger age, as a competitive endurance cyclist, one of the authors experienced AF requiring surgical treatment). However, whether AF that is medically well controlled negatively affects survival rates and quality of life in former athletes remains to be shown, and more mechanistic research is needed. It also has to be determined whether AF in endurance athletes reflects actual structural remodeling or simply low heart rates (as in larger mammals). In addition, a causeeffect relationship between endurance training and cardiac alterations other than AF ...

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“…Higher levels of physical activity are associated with a lower risk of CV events [1,2] and elite athletes live longer than the general population [3]. Nevertheless, there is debate on the dose-response relationship of exercise and CVD outcomes [4,5] and whether high volumes of exercise may accelerate coronary atherosclerosis [6,7].…”

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confidence: 99%