SubscribeWhy Do Healthy Athletes Die of Heart Attacks?
Why does it seem that so many healthy athletes suddenly die of a heart attacks - while their overweight peers outlive them? Or is it a case of complete anecdotal blindness?
A saying in the news business goes,” If it bleeds, it leads!” As a private pilot, I’m very familiar with the bold headline of a small plane crash, even if it happened half a world away! The rare death of the so-called healthy athlete, being so shocking, is always front page news. It’s not surprising that we would think it is a common event, or even that being active would engender a degree of danger.
Let’s look at the data:
The first instance of a death occurring in a ‘healthy’ athlete that I can remember - not counting Phidippides - was Jim Fixx.
He was famous for being the author of “The Complete Book of Running”, and was instrumental in
making running a popular activity in the United States. Initially, it was shocking to hear of such a fit, active man, dying suddenly while running as he did! After the whole story came out, however, it was not what was originally thought, and he actually was ‘healthier’ because of his running!
Incidences of Sudden Death
In young athletes, sudden death appears to be associated most strongly with congenital cardiac abnormalities; in older athletes, with coronary atherosclerosis.
Incidences of exercise death are low in young athletes. (Approximately 0.75 per 100,000 in young male athletes and 0.13 per 100,000 in young female athletes. In middle aged men the incidence is about six per 100,000 in each year.)
A Comparison
On the day James Fixx died, 1000 other Americans would also have died of heart attacks. Few if any would have received nationwide coverage. Yet almost all of those deaths would have occurred in persons who were sedentary, or were smokers, or who had uncontrolled high blood pressure and elevated blood cholesterol. If only those sudden deaths occurring in athletes are reported in the press, it is understandable why the public might acquire a distorted impression of the relationship between exercise and heart disease.
J N Morris, D G Clayton, et al. published the study, "Exercise in leisure time: coronary attack and death rates."
Nine thousand three hundred and seventy six male civil servants, aged 45-64 at entry, with no clinical history of coronary heart disease, were followed for a mean period of 9 years and 4 months during which 474 experienced a coronary attack. The 9% of men who reported that they did vigorous aerobic activity experienced less than half the non-fatal and fatal coronary heart disease of the other men. In addition, men aged 55-64 who reported the next lower degree of this vigorous aerobic exercise had rates less than two thirds of the others. When these forms of exercise were not vigorous they were not protective against heart disease, nor were other forms of non-aerobic exercise or high totals of physical activity per se. A history of vigorous sports in the past was not protective. In addition, men with exercise-related reduction in coronary heart disease also had lower death rates from all other causes compared to the other men.
I summary, when comparing death rates in athletes and their non-active peers, being active is always healthier.
Whew! I’m glad it turned out this way! Other wise I’ve spent a lot of time, and money on running shoes, for nothing!
Great post, Dr. J!
I remember when Jim Fixx died too-I'd been a big fan of his book. Creeped me out!
But you're right, I think part of the reason it got so much coverage was that it seemed so ironic.
It's just not as interesting when an overweight non-athlete dies young of a heart attack, but that's a much more frequent occurrence.
ReplyI've always figured it was a coverage issue because in my personal life I've known far more unhealthy sedentary people have heart problems than athletic ones.
ReplyThank you for this posting. It gave great 'food for thought' with regard to several questions that I had been mulling about. I think your conclusions make sense.
Interesting as well was the article on the young athletes. My 11 year old was recently identified as having (at first an ASD, then later defined as a PFO) congenital heart defect. Of course I was so afraid he would be one of these althletes that dies when he is in his 30's. The first doctor we saw, went so far as to say that these defects are the cause of strokes in healthy people. The article you cited never even mentioned these as the types of defects that would cause this sudden death, in fact our new cardiologist even said the PFO shouldn't even be considered a defect at all - as 25% of the population has this hole between the atrium's that should have, but never does close. I did a scan thru the article and look forward to reading it more in depth. As technology advances they find more and more 'abnormalities', that could be the cause of something and they try to connect it to something. I appreciate your research. Thanks!
ReplyWe can only hope we all die doing something we love. If you have a genetic defect chances are you are going to die from that. If you are an avid runner and it takes up a large portion of your time in a day, chances are you are going to die during that!
ReplyGreat post, Dr. J! I get a lot of people asking me questions like: "Oh, you run? Well, you know a lot of runners die of heart attacks" or "Ah, you'll need new knees before you are 30". I think a lot of it is urban legend stemming from very limited sources. Jim Fixx's death was highly publicized because it was so ironic; if a skydiver died while stepping off a curb, that would've been really highly hyped as well. Newspapers typically only put those human interest stories in that they know will get people reading their paper.
ReplyDawn!
Both the atrial septal defect (ASD) and patent foramen ovale (PFO), can now be treated, if treatment is warranted, with a non-invasive procedure. I hope this is helpful.
http://www.mc.vanderbilt.edu/reporter/index.html?ID=2633
Replyagreed, I guess it's kinda hard for us to see how a presumably 'healthy looking' person can die... apparently grim only targets the old and the ill
ReplyI was afraid the report would say that exercising was bad for you. I could see a correlation between heart attacks and strenuous exercise.
ReplyThank you for this posting.
ReplyWe can only hope we all die doing something we love.
I think a lot of it is urban legend stemming from very limited sources.
Oh, that's right, Jim Fixx!
More proof that running sucks.
ReplyThis should be another good excuse to not exercise! Thanks!
ReplyOur hearts need exercise, but they also need nutrients such as minerals to keep them functioning properly. I believe athletes are at a high risk of depleting their bodies of these nutrients while strenuously exercising. We all should actively research the value of good nutrition including minerals to protect ourselves from disease and death whether we exercise or not.
ReplyInteresting post script that I just discovered.
http://www.medicinenet.com/script/main/art.asp?articlekey=85998
ReplyHello, This is Mary
I am 36 years old with 2 toddlers. My youngest just started day care last week- which still feels a little strange. I haven't had this much time to myself in years. First thing I want to do is lose the extra pounds I put on during the last pregnancy. One of the girls next door has suggested I join her walking group two days a week. After my first pregnancy I lost around 35 pounds using the Herbalife products, but when I called the man that sold them to me three years ago he told me this week he doesn't sell them anymore. He told me to look on the internet. It's disappointing because he was really nice and he called me regularly to make sure I was using their products correctly. It was nice to have someone checking in with me every week to see how I was and it kept me motivated.
I searched on the internet for someone that sells Herbalife in New Jersey. I found many websites but I don't want
just to buy the products, I want to find someone trustworthy that sells the products so I can also meet them and get started again.
Could anybody here recommend someone in New Brunswick?
.
Thanks, Mary
ReplyI agree, this is a coverage issue. It is more common for an overweight, sedentary person to die of heart disease or failure than a healthy person so that news is more interesting.
Reply