While it is already a common sense that physical activity can lower the risk of cardiovascular disease (Temporelli, 2016), there is an article(Reynolds, 2016) tells us that acute exercise can trigger a heart attack. It is thus confusing to general public what role PA really plays in heart attack.
According to the blog author, “Exercising with unusual vigor while you are enraged or emotionally distraught could be dangerous for your heart.” However, this is not the conclusion that the original scientific study achieved. The original study was a case-control study which asked the patients who had experienced their first attack whether they had had heavy physical exercise or had been emotional before the episode(Smyth et al., 2016). The researchers did not examine how physical activity interacted with emotion, thus it is unfair to say exercising with anger triples the risk as said by the article author. The impact of physical activity and emotion was studied separately in the case-control study.
So what did the original study say about the impact of physical activity on heart attack? Should we avoid PA in order to lower our risk ? First, to be clear, the question presented to patient was “Were you engaged in heavy physical exertion?”. So exercise of moderate or light intensity is almost always considered safe. People do not have to worry about heart attack when they exercise at a level that they’re used to. Second, although the study tried to match acute MI patients with similar controls in the study, the heart attack patients had significantly less habitual PA and worse comorbidity compared to the control group. The validity of a case-control study lies in how similar the cases and controls are. This indicates that if you are a person that do not exercise regularly but suddenly have a short and intense work out, it may have a higher chance of causing a problem. But if you’re a regular exerciser, there’s no point in avoiding exercise. Third, exercise may trigger heart attack, but only under the condition that someone already have underlying CVD. If you have never had heart problem, fear of a heart attack should not be your excuse for stopping exercise.
For us practitioners, we certainly don’t want to scare anyone away from exercise because we know the benefits outweigh the risks. However, when working with populations of high CVD risks like deconditioned older adults and those with high blood pressures or dyslipidemia, the exercise intensity should be suggested or prescribed with caution. Progression in intensity and duration should be slower than for apparently healthy populations.
REYNOLDS, G. (2016). Think it’s cathartic to run angry? Think again. Retrieved from http://www.nytimes.com/2016/10/19/well/move/running-while-angry.html
Smyth, A., O’Donnell, M., Lamelas, P., Teo, K., Rangarajan, S., & Yusuf, S. (2016). Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial InfarctionClinical Perspective. Circulation, 134(15), 1059-1067.
Temporelli, P. L. (2016). [Physical activity and cardiovascular health]. G Ital Cardiol (Rome), 17(3), 176-180. doi:10.1714/2190.23654