The beginning of sports practice in adulthood, from the age of 45, when one has led a sedentary life, could be a double-edged sword.
On the one hand, it is beneficial since it prevents and helps control cardiovascular risk factors such as obesity, diabetes, hypertension, reduces “bad” cholesterol and triglycerides and increases “good” cholesterol, as well as strengthens the muscles and bones and prevents depression and cancer. But exhaustive practice at a certain age could lead to an increase in cardiovascular risk if heart artery disease is already present. This could be due to the increase in blood pressure and heart rate that occur during exercise.
Therefore, who should have a cardiological check-up?
Those people who are more likely to have underlying coronary artery disease such as:
-Patients with moderate overweight or obesity.
-Diabetic patients who also have damage to an organ such as the kidney and it has manifested itself with protein loss due to diabetes.
– Patients with high blood cholesterol levels in very high ranges: total cholesterol > 320 mg/dl or “bad” LDL cholesterol > 240 mg/dl.
– Patients with a first-degree family history of sudden death or coronary heart disease such as heart attacks or angina pectoris at an early age (< 50 years).
-Patients with multiple cardiovascular risk factors such as smoking, high cholesterol and/or high blood pressure, in whom the estimated risk of suffering a cardiovascular event such as a heart attack is greater than 5% in the next 10 years. This percentage can be estimated by your regular doctor using a formula and is known as the Framinghan Risk Score.
-Patients who have experienced symptoms such as chest pain, shortness of breath, dizziness during exertion or palpitations.
-Of course, patients who have previously suffered from cardiovascular disease.
If I meet any of the above statements, what tests would be indicated?
Initially you will undergo a thorough physical examination and an electrocardiogram and echocardiogram.
Subsequently, you will be asked for a stress test or ergometry, which allows us to see the recording of the electrical activity of the heart while you perform a gradual exercise. In selected cases, this test could be complemented with an echocardiogram during exercise and if the results of these tests are altered, a cardiac CT scan would be indicated to study the coronary arteries or, in exceptional cases, a catheterization.
How can I reduce the risk?
The ideal would be exercise supervised by a trainer, not only to promote better and progressive physical conditioning, but also to prevent possible injuries that may appear and take us away from training for months.
It is preferable to perform gradual and frequent exercise rather than intense: a frequency of 3 times a week is recommended, increasing the frequency every 6-8 weeks, until we manage to do it, if possible, 3-5 times a week. Once this goal is achieved we will focus on increasing the intensity.
If you have required a specialist doctor's assessment because you meet the items mentioned above, your doctor will indicate training guidelines and make modifications to the treatment if appropriate.
In summary, practicing sports is beneficial at any age, but if you are going to start sports in adulthood and the patient has cardiovascular risk factors or a family history, a cardiological review would be advisable.
By Dr. María José Romero Castro , cardiologist , UICAR