Cardiovascular risk profile in Japanese Olympic athletes

Abstract Background Cardiovascular (CV) disease is one of the leading causes of death worldwide. Exercise is effective in managing CV risk factors and reducing the incidence of CV disease. However, there is no consensus regarding the CV risk profile of competitive athletes. Furthermore, no studies have evaluated CV risk factors in East Asian athletes. Therefore, we evaluated the prevalence and associated factors of CV risk factors using pre-participation examination data from elite Japanese athletes. Methods We retrospectively evaluated 1081 elite athletes (570 males, 511 females, age 25.3 ± 4.7 years) who underwent pre participation evaluation for 2020 Tokyo or 2022 Beijing Olympic games. Prevalence and distribution of CV risk factors (CV family history, smoking habit, overweight, hypertension, dyslipidemia, and diabetes mellitus) were assessed, in relation to age, sex, body size and sport category (skill, power, mixed, and endurance). Results 47% of athletes had no CV risk factors and 14% had multiple CV risk factors. Dyslipidemia was the most common risk (35%), followed by overweight (23%), positive family history (4.3%), smoking habit (2.8%), hypertension (1.5%). None of the athletes had diabetes mellitus. More than 60% of male athletes had at least one CV risk factor, while more than 60% of female athletes had no risk factors. Power athletes had a significantly higher prevalence of overweight than endurance athletes (27% vs. 14%, p 0.01). Conclusion Dyslipidemia and overweight are common in elite athletes. Female athletes have a better cardiovascular risk profile than male athletes. Approximately half of elite athletes are free from all the recognized risk factors. However, a small minority presents a high CV risk profile, largely expression of lifestyle and related to modifiable CV risk factors.