Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Middle-aged individuals are exercising more and living longer. Underlying coronary artery disease is the primary cause of sudden cardiac death (SCD) in Masters athletes (> 35 years) with symptoms preceding the event in only 12-36% of cases. The risk of SCD during vigorous exercise is transiently increased in those with underlying heart disease. Pre-participation screening (PPS) can detect heart disease and prevent SCD but the optimal screening method is undefined. The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and the AHA Pre-participation Questionnaire are currently used; however, a more comprehensive risk assessment is needed. The percentage of Masters athletes that undergo current recommendations to detect heart disease is modest with the primary driver for a healthcare provider to refer an athlete for PPS is increasing age and participation in long distance events, rather than the presence of traditional risk factors. Our pilot study in 286 Masters athletes suggests that they are not immune to cardiovascular risk and 12% have significant heart disease. This present study will assess the prevalence of heart disease and risk in 800 Masters athletes. We will follow the cohort for five years to determine the incidence of, and the most effective tool for detecting significant heart disease. Study participants diagnosed with heart disease will be invited to participate in a psychological impact evaluation survey to determine the impact of a heart diagnosis through PPS to ensure optimal support in those diagnosed. This research will guide physicians and sporting organizations to determine which athletes are at risk and how to screen to prevent SCD and ensure safe sport participation. This will be the first prospective, longitudinal, large-scale (800 athletes) study in Canada examining cardiovascular risk, incidence of heart disease and examination of comprehensive screening tools in recreational and competitive athletes.