Question from Joachim Sp.: I am 7 0 years old and cycle around 9,000 kilometres a year on my racing bike. After I started to train more intensively in 2005 after leaving work, my weight dropped considerably and I was also able to stop taking my high blood pressure medication. I can complete marathons with an average heart rate of 140 to 145 without any problems. Three years ago, an ECG revealed a slight so-called ST segment depression during exercise. A subsequent scintigraphy showed a slight change in the posterior wall near the apex of the heart.
I have not been banned from doing sport, but I would like your advice on these questions: Can I continue to do endurance sport at my age with the problem I mentioned? How should I assess the limit loads, for example on a mountain? Does continuous training even lead to an improvement in the oxygen supply to the heart muscle?
Answer from Dr Robert Eifler: The ST segment depression can be an indication of a narrowing of the coronary arteries. A risk of infarction cannot be completely ruled out. Your myocardial scintigraphy provides a further indication of this. A coronary angiography could clarify this more precisely, in which a stent could be placed if necessary to keep the corresponding blood vessel open. You should also monitor other risk factors such as your cholesterol level. The discontinued beta blocker would offer a certain degree of protection for the heart, but would reduce maximum performance and pulse rate.
As far as endurance sports and cycling are concerned, I can reassure you in principle: you can still get on your racing bike. However, you should indeed refrain from maximum exertion. Your heart rate should not exceed the anaerobic threshold; you should avoid competition-like situations. Nevertheless, sport can help to improve your oxygen supply and thus prevent cardiovascular risks, even in old age.
