"ST-segment depression & exaggerated BP in older runners" by Kazumasa Manabe, Owen N. Beck et al.
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Abstract

Regular exercise is known to confer substantial benefits for cardiovascular health. However, long-distance runners with abnormal exercise electrocardiography like ST-segment depression have been reported to show a higher prevalence of exercise-induced hypertension, which may link to future cardiovascular events. In recent years, the recommendation to screen and assess cardiovascular risks has extended to various populations including chronically active and seemingly healthy older athletes. PURPOSE: In the retrospective analysis of a previous research study to evaluate walking economy in older adults, we observed a fairly high occurrence of both ST segment depression and peak systolic BP in older endurance-trained athletes. METHODS: We retrospectively analyzed prior data involving apparently healthy older adults (aged ≥65 years) who engaged in regular running (12 men and 5 women) or walking (3 men and 18 women) for exercise (at least 30 mins/bout, 3 times/week, over the previous 6 months). Participants underwent a treadmill stress test and had their BP measured by auscultation and ST-segment depression via electrocardiogram. RESULTS: ST-segment depression was detected in 4 runners (4 men) and 8 walkers (2 men, 6 women). Maximal systolic BP during exercise was significantly higher in runners with ST-segment depression than those without (P=.024) but not in walkers (P=.267). This difference remained significant even after adjusting for sex differences using analysis of covariance (P=.045). CONCLUSION: In the sample of apparently healthy physically active older adults, we found the coexistence of ST-segment depression and exaggerated BP response in older runners. These findings are consistent with the notion that the screening and assessment of cardiovascular risks should be extended to masters athletes who train regularly and are seemingly healthy.

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