Exercise fear can be fatal

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Exercise fear can be fatal, study reports

 

Benefit outweighs heart-attack risk

By Ronald Kotulak

Tribune science reporter

 

November 12, 2004

 

People who avoid exercising for fear of triggering a heart attack may actually

court early death, according to a University of Michigan study showing that even

moderate physical activity can sharply cut the chance of dying among people with

diabetes, high blood pressure and other cardiovascular risk factors.

 

In fact, people at high risk for heart disease benefit more from exercise than

healthy people who exercise, said the university's Dr. Caroline Richardson.

 

While more physicians are recommending exercise for patients with chronic health

problems, many are still reluctant to prescribe exercise to high-risk patients,

Richardson said.

 

" There's always the fear in the back of a physician's head that a patient might

have a heart attack while exercising and that it would be his advice that led to

it, " she said. " That's sort of left over from our historical belief that

physical activity was not good for people with risk factors. "

 

The study looked at a representative sample of 9,611 Americans nationwide,

starting in their 50s and early 60s, and following them for 8 years. It is the

first study that looks at the effects of exercise on people of all risk levels,

not just those who have had heart attacks or undergone surgery to repair clogged

coronary arteries.

 

Among those with the highest risk of heart disease, those who did exercise cut

their chance of dying over the eight-year period by 45 percent compared with

high-risk individuals who remained sedentary, she reported in the current issue

of the journal Medicine and Science in Sports and Exercise.

 

Healthy people who exercised cut the risk of death by 35 percent, compared with

healthy inactive people, Richardson said.

 

" If you focus all the physical activity and public health message on healthy

people to keep them healthy, you miss an opportunity to address the bulk of

mortality that's attributable to being sedentary, " she said.

 

An estimated 1.2 million Americans suffer heart attacks each year and more than

500,000 of them die.

 

The Michigan study confirms the findings of smaller studies showing that people

who have suffered heart attacks rebound faster and live longer when they do

cardiac rehabilitation that involves exercise, said Dr. Gerald Fletcher,

spokesman for the American Heart Association.

 

" This study is significant in that, safely done, people with high risk for heart

disease can exercise, " said Fletcher, a cardiologist at the Mayo Clinic in

Jacksonville, Fla. " They need to do it properly under the guidance of some type

of health professional to make sure they're doing the right thing. "

 

There is a general misconception about the risks of exercising for people with

chronic diseases, Fletcher said. Many people only remember the rare cases of

someone suffering a fatal heart attack while running a marathon or engaging in

other exercise, he said.

 

" They rationalize ways not to exercise, " he said.

 

The death-reducing benefit of exercise was seen among those who walked,

gardened, golfed, bowled or danced a few times a week, Richardson said. Aerobic

exercises, such as running, bicycling and swimming, added further improvement,

she said.

 

In the Michigan study, participants were placed in one of three cardiovascular

risk groups based on five factors: smoking, diabetes, high blood pressure, a

history of coronary artery disease including heart attack and angina, and a

history of stroke. More than 100 million Americans have one or more of these

risk factors.

 

Those with no risk factors were considered at low risk of early death. Those

with one risk factor were at moderate risk, and those with two or more factors

were considered high risk.

 

After 8 years, 810 of the participants had died. Of the people in the high-risk

group who didn't exercise, 27.8 percent had died compared with 15.1 percent of

that group who engaged in moderate to vigorous exercise. In the moderate risk

group, 8.9 percent who were sedentary had died compared with 4.3 percent of the

moderate risk group who exercised. In the low risk group, 5.4 percent of the

sedentary participants had died compared with 3.6 percent who exercised.

 

" This really shows--especially for people who already have chronic

diseases--that they can really benefit from physical activity, " said Dr. Miriam

Nelson, director of Tuft University's John Hancock Center for Physical

Activities and Nutrition.

 

" We certainly have to take precautions and make sure that people use good sound

judgment, but it's not risky for them to exercise. "

 

 

2004, Chicago Tribune

 

 

 

-LO

 

" To announce that there must be no criticism of the president, or

that we are to stand by the president right or wrong, is not only unpatriotic

and servile, but is morally treasonable to the American public. " -

Theodore Roosevelt, 7 May 1918