Pre-competitive Medical Fitness Certificate in People Over 35 Years Old: Paradoxes, Fallacies and Mysteries of a False Life Insurance
DOI:
https://doi.org/10.37615/retic.v5n3a1Abstract
In popular belief, pre-competitive medical fitness certicate is interpreted as a life insurance policy. The medical community knows otherwise. There are unmanageable variables when the athlete competes. The rate of sudden death (SD) is very low in those under 35 years of age (most causes of SD are congenital), but it is higher in those over 35 years of age. This population, in addition to being constantly growing, is the most complex to evaluate because most SDs occur due to coronary disease, which is unpredictable and undetectable with functional tests while the subclinical variant is ongoing. And the pre-competitive medical fitness certificate in those over 35 are valid for one year. Although they are useful to assess your current status with reassessment of risk factors, they cannot ensure that in the face of intense effort and other metabolic and psychological conditions, a coronary event will not be generated. We evaluated the role of pre-competitive physical fitness in this population and the role of coronary calcification in sport.
Downloads
Metrics
References
Araceli Boraita Pérez y Luis Serratosa Fernández. Muerte súbita en el deportista. Requerimientos mínimos antes de realizar deporte de competición. Rev Esp Cardiol 1999; 52: 1.139-1.145. DOI: https://doi.org/10.1016/S0300-8932(99)75044-X
M.Paz Suárez-Miera, Beatriz Aguilera. Causas de muerte súbita asociada al deporte en España. Rev Esp Cardiol. 2002; 55 (4): 347-358 DOI: https://doi.org/10.1016/S0300-8932(02)76614-1
Corrado D, Basso C, Rizzoli G et al. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003;42(11):1959–63. DOI: https://doi.org/10.1016/j.jacc.2003.03.002
Maron BJ, Roberts WC, McAllister HA, Rosing DR, Epstein SE. Sudden death in young athletes. Circulation 1980; 62: 218-229 DOI: https://doi.org/10.1161/01.CIR.62.2.218
Boraita A. et al. Sports Medicine - Open (2022) 8:116 https://doi.org/10.1186/s40798-022-0510-2
State of the Sport - Part III: U.S. Race Trends. Running USA. July 9, 2014. Available at: http://www.runningusa.org/2014-state-of-the-sport-part-III-us-race-trends. Accessed November 14, 2014.
D. Corrado, F. Migliore, C. Basso, et al. Exercise and the risk of sudden cardiac death. Herz, 31 (2006), pp. 553-558 DOI: https://doi.org/10.1007/s00059-006-2885-8
H. Kim, R. Malhotra, G. Chiampas, et al. Race Associated Cardiac Arrest Event Registry (RACER) Study Group. Cardiac arrest during long-distance running races. N Engl J Med, 2012; 366: 130-140. DOI: https://doi.org/10.1056/NEJMoa1106468
Marijon E, Uy-Evanado A, Reinier K et al. Sudden cardiac arrest during sports activity in middle age. Circulation. 2015;131(16):1384–91. DOI: https://doi.org/10.1161/CIRCULATIONAHA.114.011988
Sumeet S Chugh and José B Weiss. Sudden Cardiac Death in the Older Athlete. J Am Coll Cardiol. 2015; 65 (5): 493-502. https://doi.org/10.1016/j.jacc.2014.10.064 DOI: https://doi.org/10.1016/j.jacc.2014.10.064
Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med. 2000;343:1355–1361. DOI: https://doi.org/10.1056/NEJM200011093431902
Marijon E, Tafflet M, Celermajer DS et al. Sports-related sudden death in the general population. Circulation. 2011;124(6):672–81. DOI: https://doi.org/10.1161/CIRCULATIONAHA.110.008979
Sung K-C, Lee J-Y, Lee S-J. Physical activity and the progression of coronary artery calcification. Heart 2021;107(21):1710–16. https://doi.org/10.1136/heartjnl-2021-319346 BM DOI: https://doi.org/10.1136/heartjnl-2021-319346
Ahmed Merghani et al. Prevalence of Subclinical Coronary Artery Disease in Masters Endurance Athletes With a Low Atherosclerotic Risk Profile. Circulation. 2017;136:126–137. https://doi.org/10.1161/Circulation AHA.116.026964 DOI: https://doi.org/10.1161/CIRCULATIONAHA.116.026964
Lloyd-Jones et al. Use of Risk Assessment Tools to Guide Decision-Making in the Primary Prevention of Atherosclerotic Cardiovascular Disease. A Special Report From the American Heart Association and American College of Cardiology. JACC.2019;73(24): 3153–3167. DOI: https://doi.org/10.1016/j.jacc.2018.11.005
Gaurav S Gulsin, Alastair James Moss. Coronary artery calcium paradox and physical activity. Heart 2021;107:1686–1687. https://doi.org/10.1136/heartjnl-2021-319868 DOI: https://doi.org/10.1136/heartjnl-2021-319868
Sang-Eun Lee, Hyuk-Jae Chang, Ji Min Sung. Effects of Statins on Coronary Atherosclerotic Plaques: The PARADIGM Study. (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography Imaging. JACC Cardiovasc Imaging. 2018;11(10):1475-1484. https://doi.org/10.1016/j.jcmg.2018.04.015 DOI: https://doi.org/10.1016/j.jcmg.2018.04.015
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Martín Lombardero
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
RETIC is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license https://creativecommons.org/licenses/by-nc-nd/4.0 which allows sharing, copying and redistribution of the material in any medium or format, under the following terms:
- Attribution: you must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests that the licensor endorses you or your use.
- Non-commercial: you may not use the material for commercial purposes.
- No Derivatives: if you remix, transform or build upon the material, you may not distribute the modified material.
- No Additional Restrictions: you may not apply legal terms or technological measures that legally restrict others from doing anything permitted by the license.
