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Cardiovascular evaluation of middle-aged/senior individuals engaged in leisure-time sport activities

Comments from Erik Solberg, on behalf of the EACPR Sports Cardiology Section

Cardiovascular evaluation of middle-aged/senior individuals engaged in leisure-time sport activities: position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation.
Eur J Cardiovasc Prev Rehabil. 2010 Jun 19. (Epub ahead of print)

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Preparticipation cardiovascular screening (PPS) has mostly focused on young athletes below 35 years old. But what about adults, basically sedentary or active, who want to take part in (further) athletic activities?
This paper by Børjesson et al highlights this issue and recommends that PPS in adults should be conducted on an individual basis. Their burden of classical cardiovascular (CV) risk factors and their present fitness level, as an indication of cardio-respiratory fitness, are markers to consider. Self-reporting forms like American Heart Association Preparticipation Screening Questionnaire or the simpler Physical Activity Readiness Questionnaire may be used to define risk profile. Especially, those with high coronary risk are to be noted.  The SCORE system is recommended by ESC to define CV risk profile and defines high- and low-risk profiles precisely.
This clinically useful paper provides a guided way to evaluate the athlete individually. A positive score is based on symptoms, high-risk profile, abnormal findings on examination or positive ECG findings. The authors underline the increased risk during high-intensity activities.
The scope of the paper is to provide feasible and safe exercise prescription for adults.