World Heart Day 2022: Are fitness freaks at risk of a heart attack?

The recent death of Indian comedian Raju Srivastava, after collapsing while exercising due to a heart attack has raised many questions about over-exercising and over-exertion. Should people limit their exercise routines? Is over-exercising weakening our heart? Is our idea of being fit and lean wearing out our hearts? While it is well known that regular exercise helps strengthen the heart and lowers long-term cardiovascular risks, strenuous exercise does increase the risk of heart attacks and sudden cardiac arrests.

Generally, moderate intensity exercise of 150 minutes every week is recommended to strengthen your heart muscles and reduce the risk of cardiovascular diseases. Extending your workout routine beyond the given time does not guarantee additional health benefits. There is even a possibility that an individual is already has a greater risk than normal, either due to lifestyle or genetics.

According to the Indian Heart Association, India accounts for approximately 60% of the world’s heart disease burden (5), despite having less than 20 per cent of the world’s population. Heart disease is the number one cause of mortality and a silent epidemic among Indians. It reports that 50 per cent of heart attacks in Indians occur before the age of 50 and 25% before the age of 40.

Indians have a genetic predisposition to develop heart disease 15 or 20 years earlier than Western and Japanese populations. As our genes cannot be altered, we must look at modifiable factors like our lifestyle, sleep cycle, and stress. A healthy diet along with regular exercise is essential for maintaining physical and mental health.

High-intensity workouts and low-calorie consumption result in deficits as the body depletes its nutrition reserves. The practice of following fad diets for weight loss promotes starvation, anemia, heart disease, stroke, mental illness, etc. Your diet should be aligned with your exercise regime. It is important to choose healthy carbs to fuel one’s brain and body.

A workout requires carbohydrates to replenish the body. In addition to repairing muscle microtears, quality proteins boost blood flow post-workout. Some fats like Polyunsaturated fats are advantageous for health despite being calorically dense. One can also look for sunflower oil, soybean oil, and various nuts and seeds as they contain omega-fatty acids. To conclude, exercise should not be questioned; rather, it should be reinforced. Moderate physical activity and a healthy diet, however, are strongly endorsed for heart health

Achieving cardiovascular health is something that everyone should aim at to maintain heart health. Physical fitness may not always be the same as biological fitness which is about being healthy metabolically. As the human body ages, small cholesterol deposits or plaques build up in its arteries and can worsen with stress and biological stress such as acute infections.

Warning signs of a heart attack

Symptoms of a heart attack include:

• Having pain, pressure, heaviness, tightness, or discomfort in the arm, chest, or area behind the breastbone
• Pain in your arm, back, jaw, or throat
• Suffocation, bloating, or fullness (it may feel like heartburn).
• Feeling lightheaded, sweaty, nauseated, or vomiting
• Excessive fatigue, anxiety, or shortness of breath
• The pulse rate is rapid or irregular

What tests should be done to check cardiac fitness?

Cardiac diseases can start at an early age. To prevent further heart attacks, you should get your first BP, diabetes, and lipid profile test done at the age of 18 years and then continue every three to four years. Keeping a track of your BP during every clinical visit is also a must. Getting your ECG once every year when you turn 40 years can be helpful.  Depending on your condition, the doctor may space out the frequency. Recently, ECG patches for long term monitoring have come out, such as single lead Patch and the 7Lead patch. This newer technology has advantage of real-time analysis using artificial intelligence, which means that one does not have to wait till the end of monitoring period in the event of interim cardiac rhythm abnormalities. These are great to detect cardiac rhythm problems early on. Several common symptoms, such as dizziness, anxiety and palpitations could be due to cardiac rhythm problems and screening them early can prevent further complications, such as a stroke.

The author is Head of Cardiac Electrophysiology, Kokilaben Dhirubhai Ambani Hospital. Views are personal.

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