title: Carotid and peripheral atherosclerosis in male marathon runners.
abstract: OBJECTIVE
  We measured extracoronary atherosclerotic plaque burden and its association with cardiovascular risk factors and with coronary atherosclerosis in male marathon runners.
  
  
  METHODS
  We studied 100 male presumably healthy runners, aged 50-75 yr, who completed at least five marathons during the preceding 3 yr. Presence of plaque in the carotid, abdominal, and lower limb arteries was imaged using B-mode ultrasound. In all runners, traditional cardiovascular risk factors and the electron beam computed tomography-based coronary artery calcium (CAC) score were determined.
  
  
  RESULTS
  Ten runners were free from any plaque in the carotid or peripheral arteries. Runners with plaque were older (58±6 vs 54±5 yr, P=0.04), had a higher 10-yr Framingham risk score (7.2±3.8 vs 5.0±1.9, P=0.026), and tended to have a higher prevalence of CAC (76.7% vs 50.0%, P=0.07) compared with those without. Runners with CAC≥100 had larger peripheral artery diameters (aorta and iliac and common femoral arteries) but smaller lumen than runners with CAC<100, indicating atherosclerotic remodeling. A stepwise model selection process to predict CAC on the basis of age and peripheral atherosclerosis yielded a model as follows: log2(CAC+1)=0.181 age (yr)+0.435 maximum carotid plaque thickness (mm)-6.487, with a coefficient of determination of 22.8%. However, positive and negative predictive values were too low to predict CAC≥100 with sufficient accuracy.
  
  
  CONCLUSIONS
  The prevalence of carotid and peripheral atherosclerosis in marathon runners is high and is related to cardiovascular risk factors and the coronary atherosclerotic burden. Remodeling of peripheral arteries is greatest in runners with the most evidence of atherosclerosis. These data support an increased awareness of atherosclerosis prevalence and cardiovascular risk factors in marathon runners.
authors.affiliation: Clinic of Angiology, HELIOS Clinic Krefeld, Krefeld, Germany. knut.kroeger@helios-kliniken.de
authors.forename: Knut
authors.initials: K
authors.lastname: Kröger
authors.forename: Nils
authors.initials: N
authors.lastname: Lehmann
authors.forename: Lisa
authors.initials: L
authors.lastname: Rappaport
authors.forename: Mareike
authors.initials: M
authors.lastname: Perrey
authors.forename: Alexey
authors.initials: A
authors.lastname: Sorokin
authors.forename: Thomas
authors.initials: T
authors.lastname: Budde
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: Paul D
authors.initials: PD
authors.lastname: Thompson
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Stefan
authors.initials: S
authors.lastname: Möhlenkamp
mesh_terms: D000367:Age Factors; D000368:Aged; D001012:Aorta, Abdominal / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000503:physiopathology; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D056352:Athletes / Q000706:statistics & numerical data*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D005263:Femoral Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007083:Iliac Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012420:Running / Q000502:physiology*; D014463:Ultrasonography