The Cardiovascular Risks of Physical Activity

Abstract

ABSTRACT. The incidence of sudden death, serious arrhythmias, and myocardial infarction in connection with both recreational and rehabilitative physical activity is small. However, the incidence of e.g. sudden death is several times higher in exercise than at other times. This relative risk is highest in middle‐aged men, and higher in strenuous than in nonstrenuous exercise. In the vast majority of the cases the underlying cause is advanced coronary heart disease, which in large proportion of the cases has been asymptomatic and has allowed regular strenuous training. Attempts to prevent the complications by special large scale screening programs would be ineffective and individual councelling limited by lack of resources. These measures should, however, be used in selected groups and individuals. Another approach is to inform the exercisers and their families at large by systematic, well‐planned and repeated messages of the risks of physical activity, of the symptoms and findings indicating this risk, of the individual and environmental factors increasing the risk, and of the necessary measures to be taken to minimize the risk. Even if all available measures at present were used, the cardiovascular complications of physical activity could not be totally prevented. Fortunately, preliminary evidence suggests that at population level the cardiovascular hazards of physical activity are outweighed by its cardiovascular benefits.

Characteristics and Outcomes of Sudden Cardiac Arrest During Sports in Women

“…3,16 Similar sex difference have been also reported in smaller retrospective studies in Finland and in the United States. 27,28 The precise mechanism behind this dramatically low incidence of SCD among women during sports requires further studies, and our finding should be considered as hypothesis generating. This could include several factors: first, the total exposure time that may differ between men and women, although our calculation by million participants allowed us to exclude the issue of sport participation only.…”

Sudden Cardiac Arrest During Sports Activity in Middle Age

“…20, 21 Similar gender differences have also been reported in smaller retrospective studies in Finland and in the United States. 22, 23 Second, the duration per sports session as well as the vigor and the method of physical activity could differ between men and women. However, in considering inherent sex differences, potential explanations could include a number of factors, such as differences in vulnerable substrate (underlying structural or electrical heart disorder), triggers and/or autonomic modulators.…”

Mountain mortality: a review of deaths that occur during recreational activities in the mountains

“…Studies of long distance skiers and runners demonstrate that the incidence of SCD in adults is between 5–50 times greater during exercise than during sedentary activities 44 – 46. In most cases SCD is due to coronary artery disease and is reflected by the sex and age distribution of those who die from the condition 47. In studies undertaken in the European Alps between 90–95% of SCDs occurred in males, while the frequency of SCD has been shown to increase dramatically in those aged over 34 years 40 41.…”