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Masters players committed to the team, ignore heart health: study

15 March 2022

Soccer and other sports increasingly popular with people aged 35+

Research from the University of Sydney and Royal North Shore Hospital provides insights into cardiac risk among footballers of 'masters' age (35 years and older). 

In what is believed to be the first study to assess cardiac knowledge and beliefs in this higher-risk amateur football (soccer) group, researchers have found that one in five players experience one or more potential cardiac symptoms while playing in the past year, but only one in four of them sought medical attention.

The findings from the survey were published today in the Royal Australasian College of Physicians’ peer-reviewed journal The Internal Medicine Journal.

Associate Professor Tom Buckley from the University of Sydney’s Faculty of Medicine and Health explained although regular exercise improves health, he and others have shown previously that strenuous exercise can cause a temporary increase in risk of heart attack and sudden death. 

“Although events during sport may be rare, each death is a tragedy and insight into motivations and health behaviours of masters’ players helps plan preventative approaches,” he said.

“It is important for people to recognise and act quickly on symptoms when participating in sports events,” Associate Professor Buckley said.

“Our research is also relevant for other sports besides football, which is the most common masters team sport.”  

Professor Geoffrey Tofler, senior author of the paper, and Professor of Preventative Cardiology at Sydney Medical School and cardiologist at Royal North Shore Hospital, says: “Although regular exercise improves health, the temporary increase in cardiac risk during strenuous exercise reinforces that it is important to recognise the warning signs of an impending cardiac event. 

“If a cardiac arrest occurs, acting promptly with CPR and defibrillator availability is critical.”

“Our research provides insights for masters football players and other masters players so that they can continue to enjoy the benefits of weekend amateur sport but know when to seek help if required.” 

It is important to recognise the warning signs of an impending cardiac event.
Professor Geoffrey Tofler

Some key findings include:

  • 21.6 percent experienced at least one potential cardiac symptom during physical activity in the preceding 12 months, but only 24.2 percent of them sought medical advice. 
  • Almost half (49.6 percent) had little or no confidence that they would recognise a heart attack in themselves, with even less expressing confidence in recognising one in others.
  • In response to a hypothetical episode of chest pain while playing, less than half (46.6 percent) would leave the field immediately, while 49 percent would stay on the field for 5-10 minutes to see if the pain eased, and several A grade (16.6 percent) and B grade (2.2 percent) players would continue playing until their performance became unsatisfactory or until the end of the game.
  • Three quarters (76.5 percent) said they would use the internet for information about their symptoms before seeing a doctor.
  • Although knowledge of typical heart attack symptoms was high (>80 percent) it was lower (<40 percent) for less typical symptoms. 
  • One high-risk attitude was that nearly half (45 percent) said if they thought they were having a heart attack, they would prefer someone to drive them to the hospital rather than have an ambulance come to their home. 
  • While most (81.7 percent) would see a doctor within one week of experiencing a health problem such as chest pain, 18.3 percent would wait longer or not go.
  • A positive response was that prevention strategies were strongly supported by participants, in particular, defibrillator availability at games and training in their use, and educational information about cardiac health and warning symptoms. 

About the study

Lead author Dr Matthew Francis said the Masters Football and Cardiovascular Risk (MAFACARI) survey collected self-reported, anonymous data via a web-based questionnaire, which sampled 153 amateur masters footballers from Sydney.

Participants were of average age 49.3 ± 7.5 years, mainly male (92 percent), and from A -grade competition, B- or lower-grade competition and social games. Competitive drive and intensity of emotions while playing was greatest in the competition players.   

Dr Francis said that almost three quarters (73.3 percent) had played football for at least five years since 35 years of age, and participants exercised or played sport an average of 3.6 days per week. 

The most popular reasons for playing football were social interaction and enjoyment (93.5 percent), health and exercise (89.5 percent) and love of football (79.7 per cent).   

Co-author Mr Alexander Tofler, a student at the Susan Wakil School of Nursing and Midwifery, said players were invited to participate through researcher attendance at team sessions, or telephone and email communication with team and area coordinators who distributed study information.  

Because the level of education was high in survey participants (75 percent had university degrees), the findings may be a best-case scenario, assuming those with a lower educational level may have less awareness about cardiac issues.

The full paper is available at:

To find out more about heart-attack causes, warning signs and what to do, people are encouraged to visit the Heart Foundation resource page.

Image top of page credit: Shutterstock.

Vivienne Reiner

Media and PR Adviser (Health)
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