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Category: Exercise

I’m an athlete. I can’t have a heart attack.

If you’ve ever thought, “I exercise so I shouldn’t have any heart issues”—this is for you.

135 people have died from sudden heart attacks during triathlons in the US from 1985 until 2016 (just last year) according to a recent Internal Medicine study1.
To continue our blog theme about raising awareness of cardiac arrest and heart attack symptoms, we continue by sharing some scary statistics such as the one above. Even serious athletes are not immune to heart conditions and heart-related deaths.

The Facts

• 67 percent of these deaths occurred during the swimming portion of the triathlon (usually the first part of a triathlon)
• 85 % of the deaths were men
• In men, the risk increased substantially with age (risk was way higher for men 60 years old and older)

The Causes

Not warming up that well: The researchers commented that warming up properly could play into the cause of these heart-related deaths. By not adequately warming up, it puts an extra strain on your heart as a competitor in a serious race like a triathlon.

Denial: Denial is probably the most serious issue of them all. And in reality, most athletes lean towards denial of health issues since they have taken active steps (literally) towards being healthy.

The Coach of the Rocky Mountain Triathlon Club, Charles Perez was interviewed in a recent article about this study and he shared “once we get over 40, we start to get into denial very, very quickly. I know myself that was very true. When I first started noticing these heart arrhythmias I was in total denial this can’t be true – I’ve been running my whole life and there’s no way I can be having any sort of heart issues. It took a long time before I finally went into the doc and had it checked out and went to a heart specialist and they told me exactly what I had and gave me some options on what I could do for it.” Mr. Perez had been competing in endurance races for over 20 years when he developed Supraventricular Tachycardia which he had surgery for in 2001.

The great news is that he recovered and was able to continue doing triathlons. What we learned from all this is that we should never be in denial no matter what our regular level of exercise is.

What to look for?

They call heart disease the “silent killer” for a reason.

Heart issues often don’t have symptoms and can appear suddenly. You don’t know if you’ve got hardening of your arteries until you have what is referred to as an “event.”

By exerting your body to its highest level, a triathlon is truly like a stress test and can aggravate things to the point that an event can occur.

Signs/Symptoms may include:

• feeling dizzy
• feeling light-headed
• shortness of breath
• chest pains
• a rapid heartbeat

If it’s so SILENT, how do we try to prevent it?

According to editorialists at The New England Journal of Medicine, “Although pre-participation screening may not be popular in this older group of athletes, education (especially men over 40) about the signs and symptoms of cardiovascular disease (including the use of performance-enhancing drugs) and the need for proper medical attention is warranted.”

A physical exam by your physician if you are over 40 is not a bad idea before you start training for an endurance race of any kind.

And don’t get lazy. As we have seen with the statistics above, someone who is in good physical condition and has been involved in endurance events/races for many years can STILL be at risk for heart issues. Therefore, follow up appointments throughout your training are also important.

In conclusion—get educated and get checked regularly!

And most importantly, next time you think that because you are an avid jogger or swimmer, or that because you go to the gym that you may be immune from any kind of heart-related issues, think again. If you are a physician or healthcare practitioner and want to further your cardiology knowledge to help your patients avoid cardiac events, visit us at The Wynn in Las Vegas for our CMHC West event May 4-5, 2018! If you would like to stay aware of signs or symptoms, check out our recent blog about risk factors or visit the The American Heart Association’s website.

1Annals of Internal Medicine. http://annals.org/aim/article/2654457/death-cardiac-arrest-u-s-triathlon-participants-1985-2016-cas. September 19, 2017. Accessed October 17, 2017.
2KUSA 9News. Erica Tinsley. Heart attacks killing triathletes during race. http://www.9news.com/news/local/study-heart-attacks-killing-triathletes-during-race-1/477472167. September 20, 2017. Accessed October 17, 2017.
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How Healthy is YOUR Town?

Health
Exercise has received a lot more stage time in the recent years, especially due to the enormous focus on nutrition and the current obesity epidemic in our country.

We may personally feel like more gyms are packed and the lines are longer at grocery stores selling organic foods. It is no lie that people are more conscious of diet and staying active.

But is this just where YOU live?

An interesting article surfaced in the New York Daily News which covered exercise based on region; specifically cities in the US. A 2015-2016 Gallup and Sharecare poll showed that across 189 cities in the U.S., a person’s exercise frequency had nothing to do with where they lived.

While we would most likely agree that out of the 350,000 people polled, the ones living in metropolitan areas would be more likely to exercise a lot more, this poll proved us all wrong!

At least we were right about our earlier points:

  1. The poll showed that regions with higher rates of regular exercise also had less chronic health issues like heart attack, diabetes, obesity, and depression. Exercise = less disease, less obesity, better health.
  2. 53% of Americans were classified as “regular exercisers” in 2016. This was the highest rate on record since the same company ran the first U.S. poll in 2008. So we are on the right track!

The cities with the higher volume of exercisers are argued to have made routine exercise MORE possible for their citizens than other cities. Wouldn’t you be more likely to exercise if your city had more safe, livable, bike-able, run-able and walkable spaces accessible to you?

Now we know you are curious…who won? Who lost?

Boulder, Colorado (population of 108,000 approximately) had the highest percentage of regular exercising citizens. These people exercise three or more days a week, for at least 30 minutes a day.

NYC was almost at the end of the list (167 out of 189) and as far as who lost: Hickory, N.C. with 42%!

Are you wondering about your city? U.S. Cities ranked by Exercise Rate

New York Daily News. The surprising cities with the highest and lowest rates of exercise.
http://www.nydailynews.com/life-style/surprising-cities-highest-lowest-rates-exercise-article-1.3509233.
September 20, 2017. Accessed October 5, 2017.
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Sitting at Work? Exercise to Reduce Cardiometabolic Risk

Regular exercise outside of work can reduce the risk of metabolic syndrome in people whose jobs have them sitting most of the time, according to a small study from Brazil.

“If you have a sedentary occupation, especially in a sitting position for hours, you should move yourself out of work at least 150 minutes per week in a moderate intensity to mitigate the detrimental effects of sedentary behavior at work,” Eduardo Caldas Costa from Federal University of Rio Grande do Norte in Natal reported.

Sedentary behavior has been associated with an increased risk for metabolic syndrome – a cluster of unfavorable markers including abdominal obesity, high blood pressure and low HDL “good” cholesterol – which, in turn, is associated with an increased risk of developing heart disease and type 2 diabetes.

The researchers investigated whether Navy workers who spent about eight hours daily seated, mostly in administrative duties, had different risks for metabolic syndrome based on their activity levels outside of work.

All the workers were men, ranging in age from 26 to 42. Out of 502 workers included in the final analysis, 201, or 40 percent, did not achieve at least 150 minutes per week of moderate-vigorous activity. Nearly half, 48 percent, were overweight and almost 19 percent were obese.

After adjusting for age, time in the job, body mass index (BMI) and tobacco use, researchers found the sedentary workers who met the physical activity recommendations were only about half as likely to have metabolic syndrome, compared to those with lower activity levels.

Workers with higher activity levels were also less likely to have abdominal obesity, high blood pressure and low HDL.

Even those who increased their activity slightly (the “insufficiently active” group) had lower blood pressure than workers who remained sedentary off the job, researchers reported in the Journal of Occupational and Environmental Medicine.

“Sedentary occupation workers should break up prolonged sitting time at work as much as they can in order to reduce the risk for cardiovascular and metabolic diseases,” Caldas Costa said by email. “Be involved in regular physical activity out of work, including leisure time, domestic activities, and active transportation (i.e., walking and/or cycling).”

Only the physically active group, he added, and not the insufficiently active group, had a reduced risk for metabolic syndrome compared to the sedentary group. “Therefore,” he said, “it seems that probably there is a minimum quantity of physical activity that can mitigate the detrimental effects of sedentary behavior at work.”

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The Benefits of Bicycling

A recent study at the University of Glasgow, published in the British Medical Journal, indicates that those people who bicycle to work are 41 percent less likely to develop heart disease and cancer. While walking has clearly outlined benefits, it does not provide the same payback as bicycling.

The test was conducted with 264,337 people; compared to driving, cycling is linked to a 46 percent lower risk of cardiovascular disease. The same study demonstrated that walking reduced heart disease by 27 percent, but showed no links between lower risks of cancer or premature death.

Researchers and experts believe that the high health benefits of cycling may be linked to the fact that cyclists often travel longer distances, and exercise at higher intensities.

Dr. Jason Gill, a professor and scientist who helped execute the study, believes that the government should legislate easier ways for people to commute by bike, including the creation of “cycle lanes, city bike hire, subsidized cycle purchase schemes, and increasing provision for cycles on public transport.” These efforts have the potential to create significant opportunities for improvement of public health.

Perhaps most importantly, it is imperative to make physical activity both ‘easier and more accessible.’ Workplaces, local authorities, and the legislature should investigate ways to increase and enhance public transport—making it an ‘easy option’ to get to work.

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Move — and Move Often!

While most physicians and nutritionists agree that low to moderate levels of weekly physical activity is often insufficient to significantly reduce body weight, studies indicate that those who transition from little to no daily physical activity to moderate levels have clinically meaningful reductions in cardiometabolic risk.

Scores of controlled trials over the last decade demonstrate that physical activity helps mitigate and reduce cardiometabolic risk via biologic mechanisms, which are not entirely dependent upon body weight or BMI reduction. Research increasingly supports that those who have prediabetes should consistently increase physical activity levels, despite little to no weight loss.

According to research published in the European Journal of Preventive Cardiology, the benefits of physical activity may outweigh the impact of being overweight and/or obese in middle-aged and elderly people. The observational study, conducted with a sample size of over 5,000 people aged 55 years and older, followed up with participants for 15 years. While overweightness and obesity is associated with a higher risk of cardiovascular disease, and weight loss is recommended, it is slightly different with the elderly population: weight loss, especially unintentional, is often associated with muscle loss and death.

Regardless of age, physical activity is associated with a lower risk of cardiovascular disease. Studies have further demonstrated that physical activity is protective for cardiovascular risk, playing a crucial role in the health of middle-aged and elderly people. Without adequate physical activity, those who are overweight and obese are at a significantly higher risk of developing cardiovascular disease.

The harmful effects of overweightness and obesity occur through adipose tissue, which accelerates the atherosclerotic process, thereby increasing cardiovascular risk. Exercise and physical activity lowers the harmful effects of atherosclerosis by reducing the stabilization of plagues on blood vessels, ultimately reducing the heart’s oxygen demand. Engaging in high levels of physical activity protects people from the harmful effects of adipose tissue on cardiovascular disease. The idea: move—and move often!

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