April 6th, 2015
Cardiac Arrest During Exercise in Middle-Aged People
Larry Husten, PHD
Dropping dead while exercising is a common fear, especially among middle-aged men. Unfortunately there have been limited data on the precise rate of sudden cardiac arrest (SCA) in middle-aged people and little understanding about the medical history of the victims of SCA. Now a new study fills in some important gaps in knowledge and shows that this fear is largely misplaced, given the small risk that exercise will lead to sudden cardiac death in most middle-aged people.
In a paper published in Circulation, researchers scrutinized all SCA cases in people 35-65 years old in the Portland, Oregon area over a ten year period — the first such analysis performed in the United States, say the authors. Over the study period there were only 67 cases of sport-related SCA in the study population, representing only 5% of the total 1,247 SCA events in middle-aged people. This is “a fact that is likely to encourage sports activities among middle-aged athletes,” the authors wrote.
A second important finding is that nearly two-thirds of the people who had SCA had previous cardiovascular symptoms or had been diagnosed with cardiovascular disease. This finding “suggests that utilization of educational and general awareness approaches may further decrease sports-associated SCA burden.”
Middle-aged men were 18 times more likely to have a sport-associated SCA than women. The authors estimated that in the overall middle-aged U.S. population 2,269 men would have an event each year, compared with only 136 women. They speculated that this difference may be due to “inherent sex differences” or differences in the rate of participation or the vigor and duration of exercise.
The authors emphasized that the small increase in short-term risk associated with exercise is almost certainly outweighed by “the long-term benefits of regular exercise on cardiovascular health.” They said “the findings from this study should in no way discourage patients with cardiovascular risk factors from engaging in regular, appropriate physical exercise within a framework of simple guiding rules from the treating physician.”
Un large running a blow heat, high interna temperature play and important paper un SCA un training people according en israelite study.
For an inexpensive, low radiation coronary calcium scan we could find almost all of these middle aged weekend warriors who are at risk of sudden cardiac death. We could also find essentially everyone else at risk for heart attacks and help initiate appropriate preventive steps.
Why do we continue to embrace the minimal benefit we provide by finding and fixing obstruction yet fail so badly at finding presymptomatic disease.
With decades of investigation, the truth is available. Elective revascularization does not prevent heart attacks or reduce death. Finding disease with coronary calcium is 10X more predictive of events than conventional risk factors. Coronary calcium is also a strong motivator for behavioral changes.
In my part of the country insurance companies will pay for essentially any revascularization procedure however they do not cover coronary calcium as it is “investigational”.
Help me understand this.