A new study of more than 2,000 athletes performing at the highest levels of their field – all of whom were eligible for the summer and winter Olympic games – has exposed a surprisingly high prevalence of cardiovascular conditions.
The researchers behind the study, from the Institute of Sport Medicine and Science of the Italian Olympic Committee in Rome, Italy, presented their findings at EuroPRevent 2015, the European Association for Cardiovascular Prevention and Rehabilitation’s showcase congress.
“Even Olympic athletes,” says author Dr. Paulo Emilio Adami, “regardless of their superior physical performance and astonishing achievements, showed an unexpected large prevalence of cardiovascular abnormalities, including life-threatening conditions.”
Dr. Adami and colleagues examined 1,435 male and 919 female athletes with a mean age of 27.6 years, who underwent physical examination and echocardiography between 2002 and 2014. The examinations comprised part of the athletes’ screening to compete in the Olympic games from 2004 onwards. Some of the athletes also received 24-hour electrocardiography monitoring to confirm previous diagnoses.
An unexpectedly high amount of the screened athletes – 171, or 7.3% – had either a structural or electrophysiological cardiovascular abnormality, the study revealed.
The extent of these conditions in six of these 171 athletes was considered to be life-threatening, and they were consequently disqualified from competing. Another 24 athletes were suspended but then later allowed to compete under close medical surveillance.
The identified abnormalities included coronary heart disease and cardiomyopathies, which are among the most common causes of sudden cardiac death.
Dr. Adami says it was “really surprising” to find that Olympic athletes – a group widely assumed to be some of the healthiest individuals – had managed to reach such high competitive levels with such significant abnormalities.
The abnormalities, Dr. Adami considers, had gone undiagnosed because the athletes’ previous screenings had not been as extensive as those applied by Dr. Adami and his team. He explains:
“We cannot take it for granted that elite athletes are healthy. This study demonstrates that a more accurate assessment is necessary for elite professional athletes than for members of the general population, in view of the intensity and stress on their cardiovascular system through so many hours of training and competition. We suggest that our model of screening is applied to all elite athletes, regardless of the sport they practise.”
Dr. Adami wants to see all competitive athletes have medical evaluations to ensure that they are competing safely and are not at risk from cardiovascular problems. For noncompetitive athletes, Dr. Adami advises a visit to a sports medicine doctor or GP, especially for those who are unfit or sedentary.
In 1982, Italy introduced a program to screen all teenagers and adults in organized sport. However, studies from other countries have cast doubt on the notion that this kind of mass population screening detects all higher risk cases.
For instance, one study suggested that around 800 athletes would need to be disqualified from competing on medical grounds in order to prevent one sudden death.
However, the Italian rules – which prevent athletes from competing unless they have a clean bill of cardiovascular health – have been associated with up to an 89% decrease in incidence of sudden cardiac death among athletes in some regions of Italy between 1980 and 2003.