Over the past 35 years, 135 Americans partaking triathlon died suddenly during exercise, 44% of whom died of atherosclerotic coronary artery diseases or myocardiopathy (Harris et al., 2017). Nevertheless, the popularity of athletic events and average age of participants have increased worldwide over the past 30 years, and completing in endurance events has become a personal goal for many individuals ( Eijsvogels et al., 2016).įurthermore, the main cause of sudden cardiac death among athletes under the age of 35 has been congenital heart diseases such as hypertrophic myocardiopathy for athletes over 35 years, 70% of sudden cardiac death was induced by coronary artery diseases ( Burke et al., 1992). In addition, it has been reported that long-term endurance exercises have the potential to adversely affect the cardiac function by inducing cardiovascular diseases, and till now, no defining limit is known about the amount of exercise that improves the cardiovascular function while reducing the cardiovascular events. On the other hand, while there are numerous studies which identify physical activities and exercises to be beneficial, there are also meta-analyses involving athletes engaged in chronic exercise that reported a 5-fold risk of fatal arrhythmia, like atrial fibrillation, compared with the sedentary population ( Karjalainen et al., 1998), and enhanced coronary event rates ( Vlachopoulos et al., 2010). Excessive exercise above these recommendations that regularly engage over 20 hr per week at an intensity of 15 metabolic equivalent of tasks (MET) induces a plethora of unique electrical, structural, and functional cardiac adaptations that are collectively termed the ‘athlete’s heart’ ( Fagard, 2003 Mann and Rosenzweig, 2012). The 2008 Physical Activity Guidelines Advisory Committee Report recommended a minimum 150 min/wk of moderate intensity or 75 min/wk of vigorous-intensity aerobic exercise for an adult. In addition, regular exercise is effective for the prevention and treatment of chronic diseases such as coronary artery disease, diabetes, obesity, hypertension, cardiac failure, and depression, and reportedly extends the average lifespan of active individuals by approximately 7 years, as compared to individuals with a sedentary lifestyle ( Chakravarty et al., 2008 Haskell et al., 2007). In response to this, exercising has been highly recommended as a measure to prevent such diseases. Middle-aged individuals of the modern society are highly likely to be exposed to geriatric diseases, which are chronic disorders, due to their sedentary lifestyles and decrease in physical activities. Therefore, aiming for exercises at moderate intensity that befit the individual’s fitness level as well as conducting regular examinations to predict and manage the risk of sudden cardiac death from exercising were considered as the more effective method of cardiovascular health management. However, prolonged endurance exercises can cause cardiovascular disease which can adversely affect the cardiac function, and to date, no defining limit is known about the amount of exercise that improves the cardiovascular function while reducing the cardiovascular events. The effect of regular endurance exercises on cardiovascular health management in middle-aged men was found to be relatively positive. The following conclusions were drawn as the result of comparatively analyzing middle-aged men who regularly performed triathlon and cycling exercises for more than 5 years. This study was conducted to investigate the effect of regular endurance exercises on the management of cardiovascular health in middle-aged men.
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