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Urho M. Kujala, MD; Seppo Sarna, PhD; Jaakko Kaprio, MD

Arch Intern Med. 2003;163:1064-1068.

Background  The association between sports participation and later need of medications and dietary supplements is unknown.

Subjects and Methods  Male athletes (N = 2026) who had represented Finland in international events from 1920 through 1965 and 1401 control subjects who had been classified healthy at the age of 20 years participated in this population-based cohort study.

Main Outcome Measures  The main outcome measures were reimbursable medications for hypertension, cardiac insufficiency, coronary heart disease, diabetes, and asthma identified from the national registry from 1970 through 1998 as well as the use of nonsteroidal anti-inflammatory drugs, antacids, and specific vitamin and mineral supplements for at least 60 days during the past year reported by questionnaire in 1985.

Results  Among former top-level athletes compared with controls, the probability of initiating medication was decreased for cardiac insufficiency (age-adjusted hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.50-0.74; P<.001), coronary heart disease (age-adjusted HR, 0.72; 95% CI, 0.58-0.89; P= .002), and asthma (age-adjusted HR, 0.47; 95% CI, 0.36-0.66; P<.001). Furthermore, the risk of initiation of treatment with regular medication for hypertension (age-adjusted HR, 0.73; 95% CI, 0.54-1.00; P= .046) and diabetes (age-adjusted HR, 0.38; 95% CI, 0.20-0.73; P= .004) was reduced for endurance athletes but not for power athletes. In 1985, compared with control subjects, athletes used fewer nonsteroidal anti-inflammatory drugs (age-adjusted odds ratio [OR], 0.48; 95% CI, 0.35-0.67; P<.001) and antacids (age-adjusted OR, 0.49; 95% CI, 0.31-0.77; P= .002) but more vitamin A (age-adjusted OR, 1.87; 95% CI, 1.24-2.82; P= .003), vitamin B (age-adjusted OR, 2.26; 95% CI, 1.64-3.12, P<.001), vitamin C (age-adjusted OR, 1.96; 95% CI, 1.45-2.63; P<.001), selenium (age-adjusted OR, 1.62; 95% CI, 1.15-2.28; P= .006), and iron (age-adjusted OR, 2.35; 95% CI, 1.33-4.15; P= .003) supplements.

Conclusion  The need for long-term therapy for cardiac disease and asthma as well as for treatment with nonsteroidal anti-inflammatory drugs and antacids is reduced among former top-level athletes, but the use of dietary supplements is increased.

From the Unit for Sports and Exercise Medicine, Institute of Clinical Medicine (Dr Kujala), and the Department of Public Health (Drs Sarna and Kaprio), University of Helsinki, Helsinki, Finland. The authors have no relevant financial interest in this article.

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