Exercise and Cardiac Risk
Participating in exercise and sports is usually a wonderful experience that improves wellness in both the short and long term. In rare instances, however, vigorous exertion is associated with sudden death, It may seem difficult to understand that although regular exercise protects people from heart disease, it also increases the risk of sudden death.
Congenital heart defects (heart abnormalities present at birth) are the most common cause of exercise-related sudden death in people under 35. In nearly all other cases, coronary artery disease is responsible, In this condition, fat and other substances build up in the arteries that supply blood to the heart. Death can result if an artery becomes blocked or if the heart’s rhythm and pumping action are disrupted. Exercise, particularly intense exercise, may trigger a heart attack in someone with underlying heart disease.
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A study of jogging deaths in Rhode Island found that there was one death per 396,000 hours of jogging, or about one death per 7620 joggers per year an extremely low risk for each individual jogger. Another study of men involved in a variety of physical activities found one death per 1.51 million hours of exercise. This 12-year study of more than 21 ,000 men found that those who didn’t exercise vigorously were 74 times more likely to die suddenly from cardiac arrest during or shortly after exercise. It is also important to note that people are much safer exercising than engaging in many other common activities, including driving a car, Although quite small, the risk does exist and may lead some people to wonder why exercise is considered such an important part of a wellness lifestyle. Exercise causes many positive changes in the body in healthy people as well as those with heart disease that more than make up for the slightly increased short-term risk of sudden death. Training slows or reverses the fatty buildup in arteries, helps protect people from deadly heart rhythm abnormalities, and enhances blood sugar regulation. People who exercise regularly have an overall risk of sudden death only about two-thirds that of non-exercisers. Active people who stop exercising can expect their heart attack risk to increase by 300%.
Obviously, someone with underlying coronary artery disease is at greater risk than someone who is free from the condition. In many cases heart disease goes undiagnosed. The riskiest scenario may involve the middle-aged or older individual who suddenly begins participating in a vigorous sport or activity after being sedentary for a long time. This finding provides strong evidence for the recommendation that people increase their level of physical activity gradually and engage in regular, rather than sporadic, activity. Fortunately, the risk of heart-related sudden death in middle-aged and older adults is least in people who exercise approximately 150 minutes per week the activity level recommended by the U.S. Department of Health and Human Services. sources: Patel, V, and P. Elliot, 2012, Sudden death in athletes, Clinical Medicine 12(3): 253-256; Fahey, T D., and G, D, Swanson, 2008, A model for defining the optimal amount of exercise contributing to health and avoiding sudden cardiac death, Medicina Sportiva 12(4): 124-128, complete the assessment tests in Chapters 3-6, you will be able to set goals directly related to each fitness component, such as working toward a three-mile jog or doing 20 pushups. First, though, think carefully about your overall goals, and be clear about why you are starting a program.