Female athletes exhibited a low burden of structural heart disease despite a high prevalence of traditional risk factors such as dyslipidemia (50%) and hypertension (34%).
Observational (n=347)
No
Female athletes demonstrate excellent functional capacity and a low prevalence of structural heart disease despite a substantial burden of traditional cardiovascular risk factors like dyslipidemia and hypertension.
Abstract Background The number of women engaging in high-intensity endurance training has increased substantially over recent years; however, epidemiological data on this population remain scarce. Little is known about the cardiometabolic profile, cardiovascular diseases, and findings from exercise testing and imaging in female athletes. Understanding these characteristics is essential to refine cardiovascular risk stratification and optimize preventive strategies for women who train regularly. This study aimed to describe the clinical, metabolic, and cardiovascular profile of female athletes followed in a sports cardiology clinic. Methods This single-center, retrospective observational study included female athletes followed in a sports cardiology outpatient clinic in Brazil. Data were extracted from electronic medical records and included demographics, comorbidities, cardiovascular risk factors, sports practiced, resting ECG, maximal exercise testing, and, when available, echocardiography and coronary CT angiography (CCTA). Descriptive analyses were performed. Results A total of 347 women aged 13 to 91 years (mean 57 years) were included. The cohort consisted predominantly of runners, with more than 90% achieving 10 METs during maximal exercise testing, indicating excellent functional capacity. The most prevalent comorbidities were dyslipidemia (50%), hypertension (34%), smoking (14%), and diabetes mellitus (11%). Over one-third of the sample met criteria for high or very high cardiovascular risk. A total of 68 athletes (19.5%) had established cardiovascular disease: 24 had coronary artery disease—frequently detected by CCTA—and 21 had complex arrhythmias. Only one patient presented ventricular dysfunction. Resting ECG and echocardiography were available for all participants, revealing a low frequency of clinically relevant structural abnormalities. Left bundle branch block was observed in 8 patients and right bundle branch block in 9. Echocardiography demonstrated preserved ventricular function in almost the entire cohort. Overall, the population exhibited a low burden of structural heart disease despite the presence of traditional risk factors. Conclusion Female athletes with preserved functional capacity demonstrate a lower prevalence of structural heart disease compared with the general population and with male athletes of similar age. Nonetheless, the cohort displayed a substantial burden of dyslipidemia and hypertension, reinforcing the importance of individualized cardiovascular assessment in women engaged in regular training. These findings highlight the need for sex-specific approaches to prevention and risk stratification in sports cardiology.For image description, please refer to the figure legend and surrounding text.
Nascimento et al. (Mon,) conducted a observational in Cardiovascular risk in female athletes (n=347). High-intensity endurance training was evaluated on Clinical, metabolic, and cardiovascular profile. Female athletes exhibited a low burden of structural heart disease despite a high prevalence of traditional risk factors such as dyslipidemia (50%) and hypertension (34%).