Aims To determine the prevalence of cardiovascular disease (CVD) in world-class triathletes according to sex, sport disciplines, and formats. Methods Male and female athletes from eleven triathlon sport disciplines, ranked in the internationally yearly top 10 between 2006-2019, were included. The athlete's name was associated with key terms related to CVD or cardiac abnormalities in Google search engine. Results The prevalence and the hazard function of the variations were calculated. From 1,329 athletes (male 639, 48.08%), 12 cases of CVD were identified (prevalence 0.90%), and the mean age of their occurrence was 29 ± 7 years. One athlete died from sudden cardiac arrest (0.08%), and 4 athletes stopped their sports careers for cardiac reasons. All these severe outcomes were observed in male athletes; a significant difference was found between males and females (P = 0.03). The prevalence (P = 0.04) and the hazard function (P = 0.03) of CVD in short/medium distance were higher than in long- and ultra-long distances. The prevalence in the athletes engaged in multiple types of sports disciplines (3.55%) was significantly higher than those who merely succeeded in one type of sport (0.52%) (P = 0.002). Conclusion The prevalence of severe CVD in male triathletes was higher than females. Athletes in short/medium distance triathlon were more affected than in other disciplines. If confirmed by prospective data, this would warrant close monitoring of those populations.
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