Exercise and prevalence of cardiovascular disease in older female endurance athletes during 10 years follow-up

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): PhD student Kristoffer Johansen is funded by the Northern Norway Regional Health Authority (grant number HNF1568-21). The Birkebeiner Ageing Study has been funded by the Kavli research center for ageing and dementia and the Norwegian ExtraFoundation. Background Although research suggests that the health benefits of endurance sport practice is larger in female compared to male athletes, women are underrepresented in sports cardiology research. Furthermore, previous studies on endurance sport practice in women have mostly included younger to middle aged athletes. Thus, prospective studies addressing endurance sport practice and health among older female endurance athletes is lacking. Purpose The purpose of this study was to characterise how older recreational female cross-country skiers maintained exercise and cardiovascular health during 10-years follow up. Method Forty-six women aged ≥65 years that completed the 54-km Birkebeiner cross country ski race in Norway in 2009/2010 were included. The Birkebeiner race includes about 1000 uphill altitude meters and is considered one of the world's most challenging ski races. Participants answered a questionnaire addressing exercise habits and health issues at baseline in 2009/10 and at follow-up in 2014 and 2020. Thirty-five (76%) participants attended follow-up in 2014 and 36 (78%) participants attended follow-up in 2020. Descriptive statistics are given as mean ± SD for continuous variables and as percentages for categorical variables. Results Skiers (age 67.5 ± 2.2 years at baseline) reported a cumulative exposure to regular endurance exercise of 26 ± 15 years. The proportion reporting moderate- to vigorous exercise during the past year was 86% at baseline and 61% at follow-up in 2020. One woman died during follow up. During 10-years follow-up the cumulative prevalence of atrial fibrillation (AF) was 15.6%, more than twice as high as for other cardiac diseases (7.1%) and stroke (7.1%). Conclusion Most female athletes sustained a physically active and healthy lifestyle with advancing age. Notably, the prevalence of AF was twice as high as for other cardiac diseases and stroke. Thus, although previous literature indicates that the risk of AF in female athletes is reduced, our findings suggest that additional research is needed to draw more firm conclusions. Future studies aiming to further clarify the female athlete and AF association would greatly benefit from including older athletes that has accumulated several decades of endurance sport practice. In conclusion, further research aiming to close the knowledge gap between female and male athletes are highly warranted.