Spoooooky Effects of Exercise!!

• Welcome to the Halloween edition of The Pulsometer! Thanks for reading. 

• Vigorous activity is associated with an acute increase in cardiac events…

• … but the risk is very low, and cardiac events are much more common during other activities

• Compared to inactive people, those who exercise have a lower cardiac risk

• The more regular activity one does, the lower the risk during activity and the lower the overall risk for cardiac events

Can you die from exercise??!!

When I was a cardiology fellow I had a mentor who once shared with me that he refuses to exercise alone in his house because he was afraid he would have a cardiac arrest and no one would be there to help him. (Medical professionals take note: talking about dying while exercising in your home gym is both a huge downer and a weird flex on your poor residents.) I had frankly never considered this, partly because I didn’t have a home gym.

Incidence of cardiac events and exercise

He had a point though. Almost every year, someone dies running in in a major marathon. During vigorous activity and in the short time after, the chance for sudden cardiac death might be increased by several fold, between 3 and 17 times depending on the study. The reality, however, is that this is extremely rare. Roughly speaking, the chance of sudden death or cardiac arrest during exercise is about one in a million. During marathons, the rate of cardiac death appears to be a little under 1 in 100,000, and is slightly lower in women than men. Go, women!

About 90% of sudden cardiac events happen during something other than exercise. Furthermore, the likelihood of having a heart attack associated with physical activity is much higher in people who are usually sedentary but find them selves suddenly doing something active (like shoveling snow after months of binging Netflix).

Regular activity reduces exercise-related cardiac events

Compared to sedentary people, active people are at a lower risk for heart attacks. The more regular activity a person does, the less likely they are to have a heart attack during activity. This also underlines the importance of cardiac rehab programs after having a heart attack, which have been shown to reduce the risk of future heart events.

The bottom line on exercise

Substantial evidence supports the benefit of higher levels of cardiorespiratory fitness on cardiovascular health. Physical activity leads to improved lipid profiles, better glucose tolerance, lower inflammation, better mental health, improved heart rate variability, and improved cardiovascular function. It also improves coronary blood flow, and data suggests that if people with a physically active background have a heart attack (maybe because they didn’t know enough about their cholesterol), they tend to recover faster.

Do this:

• Share this newsletter with someone who loves to exercise regularly and someone else who has been meaning to start

• Lean in to that October theory and start an exercise habit. Remember that exercise isn’t complicated. A simple walk is probably one of the best exercises for heart health

• Eat the correct amount of your kids’ Halloween haul this week

I hope you enjoyed this newsletter. Please reply and email with questions, comments or topics of interest, and spread the word if you found value here.

As always, health is personal, and for personalized advice please consult your healthcare professional. 

Acknowledgements/References:

• Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective–An Update: A Scientific Statement From the American Heart Association- Franklin et al

• Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis- Nocon et al