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Cardiovascular Side Effects of Commonly Prescribed Medications and Performance Enhancing Drugs and Special Considerations for the Athlete

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Textbook of Sports and Exercise Cardiology

Abstract

Side effects of commonly prescribed cardiac medications such as anti-arrhythmics have specific implications for athletic performance in athletes with cardiovascular disease. Similarly, non-cardiac medications such as stimulants and anti-depressants may have more pronounced side effects in the setting of athletic activity due to the combination of endogenous and exogenous sympathetic stimulation and altered thermoregulation. This chapter is a summary of the available literature on (a) the implications of prescription medications, both cardiac and non-cardiac, on cardiovascular performance and cardiovascular health of athletic persons, and (b) the implications of potentially performance enhancing drugs known to be widely used by elite and recreational athletes on cardiovascular performance and cardiovascular health.

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Author information

Authors and Affiliations

  1. Department of Cardiology and Sports Cardiology, St Vincent’s Hospital and Baker Institute, Melbourne, VIC, Australia

    Maria Joan Brosnan

  2. Department of Health and Science, World Athletics, Monaco, Monaco

    Paolo Emilio Adami

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  1. Maria Joan Brosnan
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  2. Paolo Emilio Adami
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Corresponding author

Correspondence to Paolo Emilio Adami .

Editor information

Editors and Affiliations

  1. Private Center for Sports and Exercise Cardiology, München, Bayern, Germany

    Axel Pressler

  2. University Institute of Sports Medicine Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria

    Josef Niebauer

Review

Review

1.1 Questions

  1. 1.

    In which type of sport are beta-blockers not allowed, according to the WADA list of prohibited substances?

  2. 2.

    True or false? The dose-heart rate response to beta blockade has little individual variability.

  3. 3.

    True or false? Pulmonary vasolidators such as sildenafil have been shown to improve exercise performance at sea level.

  4. 4.

    The use of androgenic anabolic agents is associated with cardiovascular side effects which mimic what commonly inherited cardiomyopathy?

1.2 Answers

  1. 1.

    Skill sports.

  2. 2.

    False. There appears to be significant individual variability in the effect of a given dose of beta blocker on the resting and exercise heart rate. Dosing should be slowly uptitrated and exercise testing considered to assess heart rate response and exercise performance in order to tailor prescription to the athletic person’s needs.

  3. 3.

    False. There is some evidence for a performance benefit in hypoxic conditions, but this has not been replicated in normoxic (sea level) conditions.

  4. 4.

    Hypertrophic cardiomyopathy.

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Brosnan, M.J., Adami, P.E. (2020). Cardiovascular Side Effects of Commonly Prescribed Medications and Performance Enhancing Drugs and Special Considerations for the Athlete. In: Pressler, A., Niebauer, J. (eds) Textbook of Sports and Exercise Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-35374-2_27

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  • DOI: https://doi.org/10.1007/978-3-030-35374-2_27

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