Cardiovascular health in master athletes engaged in competitive sport

Abstract

Introduction: Aging is naturally accompanied by a decline in overall health. Regular physical activity, whether amateur or competitive, is recognized as a key strategy to promote health and well-being in older adults. However, many individuals begin exercising without prior cardiovascular assessment. Objective: This systematic review aimed to assess the prevalence and types of cardiovascular diseases in master athletes. Methods: Observational studies published within the last ten years were included if they evaluated cardiovascular outcomes or diseases in master athletes (aged >35 years) participating in any sport. Studies were excluded if they lacked data on predefined cardiovascular outcomes, focused solely on rehabilitation or training interventions, failed to identify the sport involved, were not available in full, or were letters to editors, commentaries, or unpublished manuscripts. The literature search strategy used the following keywords: "cardiovascular outcomes," "cardiac outcomes," "cardiovascular diseases," "cardiac outcomes" and "master athletes." Results: Ten studies were included, most involving master endurance athletes aged 35 to 90 years. Seven studies included both sexes, two included only men, and one did not specify  sex. Reported outcomes included atrial fibrillation (n=2), arrhythmia (n=2), myocardial fibrosis (n=1), ventricular dysfunction (n=1), and atherosclerotic disease (n=5). Of the ten studies, eight reported that master athletes have a higher propensity to develop cardiovascular disease, while two found no such association. Conclusion: Master athletes may face an increased risk of cardiovascular disease. These findings highlight the importance of thorough cardiovascular screening before engaging in competitive sports at older ages.