Coronary risk in a cohort of Paralympic athletes

Objective: To determine the prevalence of coronary risk factors in Paralympic athletes and evaluate their risk of coronary events. Method: An observational prospective cross sectional study of 79 consecutive Brazilian Paralympic athletes ( mean (SD) age 27.8 (6.7) years ( median 26 years)). There were 56 men and 23 women, 67 with physical and 12 with visual disabilities. The occurrence of systemic hypertension, hypercholesterolaemia, diabetes mellitus, smoking, familial antecedents, obesity, and hypertriglyceridaemia was investigated. The risk of coronary events was calculated using the American Heart Association Coronary risk handbook, and also the 10 year probability of a coronary event using the Framingham risk score. Results: The prevalence of risk factors was: systemic hypertension, 11%; familial antecedents, 10%; smoking, 9%; hypertriglyceridaemia, 6%; hypercholesterolaemia, 1.3%; obesity, 4%; diabetes, 0%. They occurred in 51% of the Paralympic athletes: one factor (41%), two factors ( 4%), and three factors ( 6%). The risk of coronary events was absent in 80%, slight in 17%, and moderate in 3%. This could only be evaluated in 81% of the athletes, as 8% had amputations, 9% were young, and 2% had unknown familial antecedents. The Framingham risk score ranged from -14 to + 6, predicting a 10 year probability of a coronary event of 3.3 (3.8)%. Conclusion: This study shows a reasonably high prevalence of coronary risk factors ( 51%), despite a low probability of coronary events in Paralympic athletes. The lipid and blood pressure profiles were similar in ambulatory and wheelchair athletes.