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Sudden Cardiac Arrest is Extremely Rare in Women
During Exercise
Study of large group of mature women over 28 years says
exercise may significantly lower risk
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Exercise
Unlikely To Cause Sudden Cardiac Death in Women
Risk is approximately 19 times
higher in men.
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March 21, 2006 - Sudden cardiac death during
exertion is an extremely rare occurrence in women, and regular moderate
to vigorous exercise may significantly lower the long-term risk,
according to a study in the March 22-29 issue of JAMA, a theme issue on
women’s health. Thousands of women, including senior citizens, were
studied over 28 years.
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Christine Albert, M.D., M.P.H., from Brigham and
Women’s Hospital, Boston, presented the findings of the study today at a
JAMA media briefing on women’s health in New York.
Regular exercise has several cardiovascular
benefits and 30 minutes or more of moderate-intensity exercise almost
every day is recommended for healthy adults. Despite the known benefits
of exercise, studies have also documented associations between incidents
of exertion and sudden cardiac death. Although such deaths are
relatively rare, they usually occur unexpectedly among people who appear
quite healthy.
The main study end point was sudden cardiac death
occurring before June 1, 2004. A cardiac death was considered sudden if
the death or cardiac arrest that precipitated death occurred within one
hour of symptom onset as documented by medical records or reports from
next of kin.
Unwitnessed deaths that could have occurred within one hour
of symptom onset and that had autopsy findings consistent with sudden
cardiac death were considered probable sudden cardiac deaths and also
were included in the analysis.
Dr. Albert and colleagues used data from the
Nurses’ Health Study to determine the risk of sudden cardiac death in
women during moderate to vigorous exertion. The Nurses’ Health Study
began in 1976 when 121,701 female registered nurses, aged 30 to 55
years, completed questionnaires about their coronary heart disease (CHD)
risk factors, lifestyle and medical history. The women have been
followed up every two years, for up to 28 years. For this analysis,
84,888 women provided information on their amount of moderate to
vigorous exercise per week in 1980, 1992, 1996, 1998 and 2000.
The youngest of these women would have been 54 for
the last analysis of data from 2000. The oldest would have been 79.
There were 288 cases of sudden cardiac death among
the 84,888 women who completed the 1980 questionnaire. The researchers
found that only nine of these deaths actually took place during moderate
to vigorous exertion, and that only three of these happened while the
women were exercising. Of 69,693 women without a history of CHD, stroke
or cancer at the study’s beginning, 32 percent (22,172) reported no
regular moderate to vigorous exercise and 15 percent (10,680) reported
exercising for four or more hours per week.
The absolute risk of sudden cardiac death
associated with moderate to vigorous exertion was “exceedingly low,” the
researchers found, at 1 per 36.5 million hours of exertion. Risk of
sudden cardiac death was temporarily elevated during moderate to
vigorous exertion, compared with the risk during lesser or no exertion.
Regular moderate to vigorous activity lessened this temporary risk, and
was also associated with a lower long-term risk of sudden cardiac death.
“Although our data are consistent with prior
analyses in men that suggest that physical exertion may trigger sudden
cardiac death and that habitual exercise diminished this risk, the
magnitude of the risk is much lower in this cohort of women compared
with a similar cohort of men,” the authors write.
“In summary, sudden cardiac death during exertion
is an extremely rare event in women, and exercising regularly can
significantly minimize risk. Therefore, these data should provide
reassurance that moderate to vigorous levels of exercise can be
prescribed in a safe fashion to women, and if performed regularly,
exercise may even lower long-term risk of sudden cardiac death,” they
conclude.
This work was supported by grants from the National
Institutes of Health.
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