Introduction:
Regular physical activity is associated with a lower risk for all-cause mortality, and the increase in death risk reduction was largest for vigorous exercise. However, vascular adaption to excessive training could alter normal physiology and promote an increased cardiovascular risk in elite athletes.

Aim:
In this study we investigated standardized surrogate markers of cardiovascular risk and subclinical atherosclerosis, such as IMT, pulse wave velocity, augmentation index, assessed at carotid and femoral arteries, and endothelial function, in 50 elite male athletes, before and after sport seasons, on a 2-year follow-up.

Material and methods:
The study population consisted of 50 healthy Caucasian male elite athletes and 40 healthy male controls. We performed ultrasound vascular assessment to assess carotid and femoral intima media thickness and compliance during a 2-year follow up.

Results and discussion:
We reported a slower increase of carotid IMT of athletes in comparison to controls. Femoral compliance of athletes was higher than control compliance after 2 year follow up.

Conclusions:
The worsening of femoral pulse-wave velocity and stiffness values at femoral arteries could be the result of a sport specific phenomenon. Physical activity differentially affects vascular beds in elite athletes, and in elicited district by strenuous exercise, we reported the progression of early markers of atherosclerosis.