King of Hearts: The One Bet That’s Well Worth It

Last summer I went to the American College of Sports Medicine (www.acsm.org) Annual Meeting in Denver where I sat in on a lecture about the dangers of overexercise. The doctor who presented it was from a Midwestern City University where he’d seen many patients come in with cardiac troubles from shoveling snow.

His basic thesis was that sudden overexercise is more dangerous than chronic overexercise…but, due to the ubiquity of the former, the latter gets more press.

No death is a good one but, for those who train and compete vigorously in aerobic sports like jogging, running, cycling, cross country skiing, etc., the one death that hurts the most is the one that keeps them from doing their sport of choice. For some, as a good friend attested to even before he got diagnosed with a cardiac condition, which has not stopped him from completing several half and full marathons, and triathlons while living at 9000 ft in Colorado. They’d rather “bust than rust”.

Thus, when I get to re-read an article in the lay press that, of course, tries to catch eyeballs, I get defensively testy. This one in the Washington Post strikes fear into aerobic athletes and those who are considering becoming so with a dooming headline only to complete the tale with encouraging news.

It is true that ones genetic predisposition and pre-healthy lifestyle impacts ones heart health such that no amount of cardio conditioning and/or perfect diet can totally reverse ones heart disease risk. That said, no matter how healthy one lives ones life, you’re still going to die…of something. It may be now, it may be way later, but even elite athletes’ hearts will give out on them someday.

So, while the title to the article – “If you exercise a lot, you probably think your heart is in good shape. Maybe not” – conveys a warning sufficient to justify not exercising a lot. The rest of the article supports the one factoid we do know: even with a bad heart, the ability to exercise, especially vigorously, makes the heart stronger.

Going back to the lecture at the ACSM meeting. The doc pointed out, as did the article in the Washington Post, that cardio athletes who incur a cardiac event are both rare and more resistant to persistent reductions in quality as well as quantity of life.

Those who suffer a heart attack shoveling snow – which is a particularly dangerous activity for a variety of reasons not the least of which is that it entails a powerful isometric component – tend to be less fit and less trained in that type of activity, unless digging is their job. So not only is it a relatively rare event, it is also one that requires going from a seated position, post-meal, to an active movement just a few times or more a season.

Imagine a healthy person jumping up from breakfast and running a half marathon without prior training. Now imagine how many injuries and cardiac events will happen under those circumstances. Salt intake can also cause high blood pressure , in turn causing cardiac events.  Read more here, and here

Runners, even marathoners, train regularly for their events. They may have less than healthy hearts but ones that are sufficiently strong enough to even support their entry into the event due to prior training. So that when the race starts, they are in fact fit and ready, generally warmed up and near steady state, aerobically-speaking, and had trained close to if not up to the length of the race itself priorly.

When such an athlete has a cardiac event, as the WaPo article and ACSM lecturer noted, it has generally been the case that they’d had some adverse symptoms they failed or chose to respect, and had not seen a doctor. Denial? Sure, but what athlete hasn’t?

Bottom line, though, is that these are so few – out of 10.9 million runners of half and whole marathons over an 11 year period. There were only 42 cardiac deaths among a paltry 59 cases of cardiac events. That means the odds of a heart attack while running are 0.00000541, or 1 out of 185,000. This is slightly less than pulling 4 of a kind in poker: 1 out of 4,165.

If I were a betting man, I’d put my money on the King of Hearts – running or any other aerobic conditioning activity – well before I put my money on drawing four of them at a Vegas poker table.