Chronic Prescription Medication Is Associated With A History Of Exercise Associated Muscle Cramps In Runners

Abstract

INTRODUCTION: The prevalence of chronic prescription medication (CPM) use in recreational distance runners is 12.5%. CPM use in endurance athletes is associated with a history of exercise associated muscle cramps (hEAMC), but which main categories of CPM are associated with hEAMC has not been explored. PURPOSE: To determine the association between the use of main categories of CPM and a hEAMC. METHODS: 76654 consenting entrants (71.8% of all entrants) in two annual races (21.1 km & 56 km) were studied from 2012-2015. CPM use and type of medication in 8 main categories were self-reported as part of an online pre-race medical screening questionnaire at race entry. Entrants reported demographics (age, sex, and race distance), CPM use in 8 categories (blood pressure-lowering, asthma, cholesterol-lowering, anxiety/depression, allergy, any diabetes, any heart, other medication) and hEAMC. The prevalence (%; 95%CI) and prevalence ratio’s (PR; 95%CI) of main categories of CPM use in runners with (E group) and without hEAMC (C group) are reported, using a multinominal logistic regression model (adjusted for age, gender, and race distance). RESULTS: CPM use was significantly higher in the E vs. C group for main categories of medication use (prevalence in %; PR in decreasing order; 95%CIs): allergy (E: 1.5; 1.2-1.8 vs C: 0.8; 0.7-0.9, PR = 2.1; 1.7-2.6; p < 0.0001); asthma (E: 3.9; 3.5-4.3 vs C: 2.4; 2.3-2.5, PR = 1.8; 1.6-2.0; p < 0.0001); anxiety/depression (E: 3.0; 2.6-3.4 vs C: 2.1; 2.0-2.2, PR = 1.6; 1.4-1.8; p < 0.0001); any diabetes (E: 0.9; 0.7-1.1 vs C: 0.6; 0.6-0.7, PR = 1.5; 1.2-2.0; p < 0.01); blood pressure-lowering (E: 3.8;3.4-4.2 vs C: 3.0;2.8-3.2, PR = 1.4;1.3-1.6; p < 0.0001); cholesterol-lowering (E: 3.6; 3.2-4.0 vs C: 2.9; 2.7-3.0, PR = 1.4; 1.2-1.6; p < 0.0001). CONCLUSIONS: CPM use is associated with hEAMC in endurance athletes and may contribute to EAMC. Specific main categories of medication associated with >1.5X risk of hEAMC are allergy medication, asthma medication, medication to treat anxiety/depression, and any diabetes medication.