Here's another reason to get up off the couch and
get moving: Regular exercise can help prevent sudden
cardiac arrest, especially if it's kept up over the
long term.
Women who did no regular exercise or very low levels
of exercise -- less than two hours a week -- faced
6.4 times the risk of having their heart stop suddenly
during or soon after a workout than women who regularly
engaged in moderate or vigorous exercise for more
than two hours a week, according to new research presented
Thursday at the Heart Rhythm Society's annual meeting
in New Orleans.
Exercise does tax the heart, so the study did find
an overall six-fold increase in the risk of sudden
cardiac death during exercise or within the hour immediately
following a moderate-to-vigorous workout.
But the researchers also found that a program of
regular exercise reduced this overall risk of sudden
cardiac death: Women who exercised four to seven hours
a week cut their odds for such an event in half, compared
to women who exercised less.
All things considered, "exercise over the long
term is beneficial for the risk of sudden death. There's
a transient increased risk during and right after
exercise that is improved with more regular exercise,"
explained one of the study's authors, Dr. William
Whang, a cardiac electrophysiology fellow at Massachusetts
General Hospital in Boston, Mass.
Whang said it was important to note that the "absolute
risk of sudden death during exercise is extremely
low -- about one sudden death per 18 million hours
of moderate to vigorous exercise."
Dr. Stephen Siegel, a cardiologist at New York University
Medical Center, said this is an old and somewhat complicated
issue.
"The performance of exercise increases the
risk of sudden cardiac death, but if one exercises
regularly, that risk is less," Siegel explained.
Sudden cardiac death is not a heart attack. During
a heart attack, a blockage forms that stops blood
flow to the heart, depriving it of oxygen. In sudden
cardiac death, the heart simply stops. While this
stoppage is often linked to irregular heartbeat (arrhythmia),
in many cases doctors just don't know the underlying
cause.
According to the Heart Rhythm Society, risk factors
for sudden cardiac death include high blood pressure,
diabetes, high cholesterol, sedentary lifestyle, obesity,
smoking, poor diet, heart rhythm problems, a racing
heart beat that comes and goes even if you're resting,
and fainting with no apparent cause.
Whang and his colleagues gathered data for this study
from the Nurses' Health Study, a large ongoing research
effort. Information on exercise participation was
collected in 1986, 1988, 1992, 1996, 1998 and 2000.
The researchers obtained information on almost 70,000
women with no history of heart disease or stroke at
the start of the study. In the 18 years between 1986
and 2004, 140 women included in the study died from
sudden cardiac death.
Moderate to vigorous exercise included brisk walking,
plus activities more intense than that, such as running
or playing tennis, according to Whang.
The researchers found that during and within an hour
of a moderate-to-vigorous exercise session, the average
woman's risk of sudden cardiac death rose 6.2 times
higher than when sedentary. However, for "couch
potato" types (women who exercised less than
two hours per week) that risk was significantly higher
-- 20.9 times higher than when sedentary.
Regular exercise brought the odds of sudden death
back to more comfortable levels. Women who worked
out more than two hours a week saw their risk of sudden
cardiac death during exercise fall to a level of just
3.3 times higher than when sedentary.
More importantly, increasing amounts of regular exercise
also appeared to reduce a woman's overall risk of
dying from sudden cardiac death, regardless of the
time it occurred.
The researchers found that women who exercised two
to four hours weekly had about a 10 percent decrease
in sudden cardiac death risk, while women who spent
four to seven hours a week working up a sweat reduced
their risk by 56 percent. Women who worked out more
than seven hours a week had a 69 percent decrease
in risk, according to the study.
After adjusting for other risk factors, such as body
mass index, diet, diabetes and more, the researchers
found that the threshold for real heart-healthy benefits
kicked in when women exercised for more than four
hours a week. At that point, risks for sudden cardiac
death begin to noticeably decline.
"One of the most critical things to do to improve
your cardiac health and well-being is to exercise
on a regular basis," advised Siegel. "Although
not without risk, the overall benefit of exercising
far exceeds the temporary risk."
Both Whang and Siegel said anyone who hasn't been
active should start off slowly, and for most people,
it's a good idea to check with their doctor first.
According to Siegel, anyone who has been sedentary
and has risk factors for heart disease, such as smoking,
diabetes, high blood pressure, high cholesterol or
a family history of heart disease, should definitely
see their doctor before beginning an exercise program.
He also cautioned that individuals who experience
any chest discomfort or pain during a workout should
immediately stop exercising and seek medical attention.
More information
The Heart Rhythm Society has more information about
sudden
cardiac death.