Exercise and Sudden Death
We exercise to prolong life and to remain fit. Now and then we
hear of football players who die on the fields.These are young professionals
who train hard and yet they die suddenly on the field.
There is yet another group of middle aged men who train
for marathons or lift weights. Frederick Montz, David Nagey, or Jeffrey
Williams, three brilliant physicians at Johns Hopkins University who died while
running. The oldest of the three was 51.
One of the things on my bucket list was to run a marathon which I
trained and did when I was 50 years of age. I ran 2 others before my wife put
an end to it by saying it was going to kill me one of these days.
Thomas Bassler, M.D., went
so far as to say that anyone who could finish a marathon in less than 4 hours
could not have serious heart problems. He conducted a study on 14 marathoners
who had died of cardiovascular disease, and concluded that all were
malnourished.
Marathon runners are fit guys who have to exercise regularly if
they need to complete in 4 hours. But now no one believes that endurance training
confers immunity.
"I think the risk is inescapable, and it's bigger than we're
letting on," says Paul Thompson, M.D., director of preventive cardiology
at Hartford Hospital in Connecticut and a researcher who studies sudden death
and exercise.
Dr. Thompson's studies showed that 10 percent of the heart attacks
treated were exercise related. "Those heart attacks tend to be in people
who aren't fit," he says. "But that doesn't mean that's the only
group that gets it, unfortunately. There are these very fit guys who go out for
a run and drop dead
According to an often-cited 1982 study published in the New England
Journal of Medicine:
·
One death per 17,000 men who exercise vigorously
1 to 19 minutes a week
·
One death per 23,000 men who exercise vigorously
20 to 139 minutes a week
·
One death per 13,000 men who exercise vigorously
140 or more minutes a week
·
Regular exercise reduces the risk of sudden
death in persons with latent coronary artery disease; but increases the risk of
sudden death during exercise for those with heart disease that predisposes to
sudden death
Heart diseases with exercise associated sudden death are
coronary artery disease and hypertrophic cardiomyopathy. Less common cardiac
disorders leading to sudden death in athletes include anomalous origin of the
coronary arteries, aortic rupture associated with Marfan's syndrome,
myocarditis, mitral valve prolapse and various arrhythmias.
"The person who's at greatest risk of an exercise death is
the person with known or hidden coronary artery disease who is habitually
sedentary all year round," says Franklin.
You don't need to turn into a marathoner.But you should work out
frequently; many studies have shown that the overall amount of time you spend
up and moving matters is worth it.
Some endurance exercise is fine, if you like it. Strength training
is probably more than fine ; it specifically prepares your body for the shock of
sudden, strenuous exertion which is most likely to kill you if your body isn't
ready for it.
But any time you exercise strenuously, on the road or in the squat
rack, you're taking on a small risk of a big problem. "It's like investing
in the stock market," says Dr. Thompson. "You're putting your money
down, looking for a long-term gain. But you could put your money in WorldCom
and lose it all. There's a risk to everything."
