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Sports Medicine Conference

Posted By: KP
Date: Tuesday, 9 October 2007, at 12:57 a.m.

Lectures are fast and full. My notes are only guidance from what I heard, not necessarily exactly what was said. I pulled parts of day 1 out below.

Pearls from day 1 conference:

Hypertension:
1) Is the most common cardiovascular disease in the world and this holds true for athletes as well.

2) For aged over 50, systolic pressure of >140 increases risk.

3) Risk for CVD (cardio vascular disease) starting at BP of 115/75 doubles every increase of 20/10.

4) 35% of men and 45% of women with HBP have unrecognized myocardial infarction. Scaring is later seen on imaging or angiographs.

5) Hypertension makes athletes less able to shunt blood to the skin, lowering one’s ability to cool off (heat stress).

*Sports Enlarged Hearts – sport induced myocardial hypertrophy enhances the delivery of blood, increasing efficiency. However, the heart returns to baseline after two weeks of detraining.

Immune Systems:
1) compromised with heavy exercise (50% increase in upper resp. infection)
2) moderate exercise strengthens immune systems
3) sedentary lifestyle compromises immune systems

Lipid Profiles:
1) exercise benefits lipid profiles
2) LDL affected only slightly
3) HDL can show major increase
4) Triglycerides can show major increase

Exercise appears to decrease endocrine cancers: breast, colon, prostrate // as well as decreasing metabolic syndrome and cardiac heart disease.

GI problems in athletes:

Upper GI – dysphagia, reflux, vomiting – seen in 50% of athletes
1) exercise delays gastric emptying
2) decreases tension of Lower Esophogeal Sphyncter (LES) meaning reflux
3) slower motility with dehydration
4) stress increases GI symptoms // 57% of road racers have GI symptoms

*GI blood flow is reduced in excess of 50% at 60% VO2max effort.
This predisposes to gut injury, increases occult blood loss and resultant endotoxins increase diarrhea.
Artificial sweeteners can cause diarrhea (sorbital).

Lower GI – runners trots or diarrhea – seen more often in runners, more often in females, more often in young.

Causes of trots: dietary, NSAIDs, heat, emotional stress, // rarely chrons

Gastric emptying is slowed with dehydration. Exercise increases catecholamines which suppress thirst. 80% of marathoners with weight loss of >4% have GI issues.

Depression:

180min a week of exercise means 40% reduction of depression; very similar results to use of drug therapy. Potential patients should try exercise prior to meds.

Dementia:

Over 65 shows decrease of 40% with history of exercise 3+ times a week.

Cardiac symptoms:

Elite athletes have hearts that act differently. They do not test textbook. Highly fit people may have 3rd degree AV block, may have V-tach with or without problems. These are certain risk factors in sedentary people.

Endurance training shows a 5.5x greater incidence of atrial fibrillation; however, lower mortality rates.

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