IMR Press / RCM / Volume 23 / Issue 12 / DOI: 10.31083/j.rcm2312405
Open Access Review
How to Unmask Hidden Cardiovascular Diseases through Preparticipation Screening in Master Athletes?
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1 Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland
2 Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, 04-635 Warsaw, Poland
*Correspondence: z_kinga@wp.pl (Kinga Zujko)
Academic Editor: Lee Stoner
Rev. Cardiovasc. Med. 2022, 23(12), 405; https://doi.org/10.31083/j.rcm2312405
Submitted: 28 September 2022 | Revised: 9 November 2022 | Accepted: 16 November 2022 | Published: 12 December 2022
(This article belongs to the Section Diet and Physical Inactivity)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Cardiovascular disease (CVD) is the most common cause of death globally in general population. Sport activity is an effective and recommended non-pharmacological method of CVD prevention. Presently, the group of people practicing sport regularly is constantly growing due to increasing awareness of its health benefits. However, vigorous-intensity exercises can reveal previously undetected disease. Master athletes over 35 years old are particularly exposed to sudden cardiac death (SCD) mainly in the course of coronary artery disease (CAD). Another common disease in veteran athletes is hypertension. It is known that regular endurance training can lower blood pressure at rest, so arterial hypertension in athletes is usually masked by adaptation to effort. Despite of normal or high-normal blood pressure in the office, the values during exercises and in ambulatory blood pressure monitoring (ABPM) can exceed the norm. Hidden hypertension have the same negative impact on cardiovascular system. It increases the risk of (1) atherosclerosis and therefore myocardial infarction or stroke, (2) left ventricular hypertrophy with diastolic and/or systolic heart failure, myocardial fibrosis and ventricular arrhythmias, (3) left atrial enlargement increasing the risk of atrial fibrillation and stroke and (4) aortic dilation/dissection. Through these complications hypertension can lead to SCD during sport activities, therefore it is important to recognize this disease early and start a proper treatment. To enable safe participation in sports competition detailed guidelines for screening were created, but they mainly concern CAD. We propose an additional scheme of screening in master athletes including the detection of hidden hypertension to prevent its consequences.

Keywords
cardiovascular disease
hidden hypertension
cardiovascular risk factors
sudden cardiac death
master athletes
endurance training
preparticipation screening
prevention
athlete's heart
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