Exercise and Your Heart Attack Risk

Most people know to check with their doctor before starting a vigorous exercise program after the age of 45. But sometimes even younger people in the best of shape experience heart attacks or even cardiac arrest during strenuous exercise. Let's look at the latest research to discover the risks and related health concerns.

Studying Marathon Runners   

The frequency of sudden deaths caused by vigorous physical activity has best been documented for marathon runners. The good news is that the overall risk of suffering from cardiac arrest for these runners is low, as reported in a recent issue of the New England Journal of Medicine. Between 2000 and May 31, 2010 cardiac arrests occurred in 1 of 100,000 out of a total of 10.9 million participants in full marathons. Of those who did suffer from cardiac arrest, however, it was fatal in 71 percent of the people. 

Perhaps surprising, the average age of those with cardiac arrest was only 42 years. Coronary heart disease (CHD) accounted for most of the events that occurred, which were relatively more common among men than women. The numbers also showed that the incidence of cardiac arrest among male marathon runners has increased significantly during the last 5 years.

Heart Attacks and CHD Are More Common for Athletes

Another article in the same issue of the journal described three male athletes, ages 45, 49, and 55, in good condition without diagnosed CHD. These men experienced an acute heart attack immediately after completing the 2011 Boston Marathon. During their hospitalization, severe CHD was discovered in the 45 and 49-year-old men. Fortunately, all three recovered after undergoing angioplasty and stent implantation procedures. Although the risk of cardiac arrest is small during a marathon, the latter article shows that heart attacks are not uncommon during or following a marathon. Both articles also illustrate that apparently healthy, relatively young men with no symptoms may harbor severe CHD and need to see a physician before beginning vigorous physical activity.

Previous Studies Link Sudden Death to Pre-existing Conditions

Earlier studies had shown that sudden death among young athletes during vigorous activity is most often due to hypertrophic cardiomyopathy—a disease that causes the heart muscle to thicken—among young athletes. Other causes of sudden death in young athletes are inherited anomalous coronary arteries (abnormal arteries), and conditions that can trigger dangerous heart rhythm abnormalities.

In recent years, the realization that these heart abnormalities are possible to detect with a careful examination and diagnostic tests have led many to advocate a detailed cardiac evaluation before students are cleared to participate in vigorous school sports.

The bottom line: no matter what your age, you should exercise regularly (train) before engaging in a marathon or other prolonged physical exertion. In addition, visit your doctor for diagnostic tests in advance of such strenuous exercise. 

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