According to this recent analysis published in Eur Heart J, women would have a far lower chances of dying suddenly for physical exertion during sports compared against men.
Women seem to be better protected against this event, which rises the following question: what the value of screening?
The risk of sports related sudden death is considerably lower in women. It occurs 5 to 33 times less frequently in women vs. men, regardless the number of participants, the sport, or exercise intensity. Whatever the reason might be, data are conclusive.
What makes data collection hard is there is too much screening before enrollment, especially in Europe. The point is whether it is worth to submit women to such tests.
In the United States, one study reported a sudden death incidence of 0.66 per million athletes/year in women, while the number reached 5.01 per million athletes/year in men. This difference cannot be overlooked.
In Germany, on the other hand, figures were 0.2 in women vs 2.6 in men.
Many suggest the difference might be driven by the type of activity or its intensity. However, when assessing identical sports and equivalent performance the difference remained the same.
There are differences in ventricular remodeling, fibrosis and atherosclerosis that result from prolonged intense exercising. All these parameters show differences between the sexes that might be due to specific variations in hormones, blood pressure or autonomic tone.
The “systematic search” for cardiovascular conditions in women before taking part in sports continues under debate among cardiologists. In Italy, for example, it is mandatory to test all participants prior sports events. Societies such as the European, AHA or ACC recommend systematic screening of competitive and professional athletes, but they have different protocols. In the United States, baseline resting ECG is not recommended as a massive screening procedure.
Original Title: Risk of sports-related sudden cardiac death in women.
Reference: Deepthi Rajan et al. Eur Heart J. 2021 Dec 11;ehab833. Online ahead of print. doi: 10.1093/eurheartj/ehab833.
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