Exercise And Acute Cardiovascular Events: Placing The Risks Into Perspective

Exercise and Acute Cardiovascular Events: Placing the Risks Into Perspective: A
Scientific Statement From the American Heart Association Council on Nutrition,
Physical Activity, and Metabolism and the Council on Clinical Cardiology
In Collaboration With the American College of Sports Medicine, Paul D. Thompson,
Barry A. Franklin, Gary J. Balady, Steven N. Blair, Domenico Corrado, N.A. MarkEstes, III, Janet E. Fulton, Neil F. Gordon, William L. Haskell, Mark S. Link, Barry J.
Maron, Murray A. Mittleman, Antonio Pelliccia, Nanette K. Wenger, Stefan N.
Willich and Fernando Costa
Circulation 2007;115;2358-2368; originally published online Apr 27, 2007;
DOI: 10.1161/CIRCULATIONAHA.107.181485
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AHA Scientific Statement
Exercise and Acute Cardiovascular Events
Placing the Risks Into Perspective
A Scientific Statement From the American Heart Association
Council on Nutrition, Physical Activity, and Metabolism
and the Council on Clinical Cardiology
In Collaboration With the American College of Sports Medicine
Paul D. Thompson, MD, FAHA, Co-Chair; Barry A. Franklin,PhD, FAHA, Co-Chair;
Gary J. Balady, MD, FAHA; Steven N. Blair, PED, FAHA; Domenico Corrado, MD, PhD;
N.A. Mark Estes III, MD, FAHA; Janet E. Fulton, PhD; Neil F. Gordon, MD, PhD, MPH;
William L. Haskell, PhD, FAHA; Mark S. Link, MD; Barry J. Maron, MD;
Murray A. Mittleman, MD, FAHA; Antonio Pelliccia, MD; Nanette K. Wenger, MD, FAHA;
Stefan N. Willich, MD, FAHA; Fernando Costa, MD, FAHAAbstract—Habitual physical activity reduces coronary heart disease events, but vigorous activity can also acutely and transiently
increase the risk of sudden cardiac death and acute myocardial infarction in susceptible persons. This scientific statement
discusses the potential cardiovascular complications of exercise, their pathological substrate, and their incidence and suggests
strategies toreduce these complications. Exercise-associated acute cardiac events generally occur in individuals with structural
cardiac disease. Hereditary or congenital cardiovascular abnormalities are predominantly responsible for cardiac events
among young individuals, whereas atherosclerotic disease is primarily responsible for these events in adults. The absolute rate
of exercise-related sudden cardiacdeath varies with the prevalence of disease in the study population. The incidence of both
acute myocardial infarction and sudden death is greatest in the habitually least physically active individuals. No strategies have
been adequately studied to evaluate their ability to reduce exercise-related acute cardiovascular events. Maintaining physical
fitness through regular physical activity mayhelp to reduce events because a disproportionate number of events occur in least
physically active subjects performing unaccustomed physical activity. Other strategies, such as screening patients before
participation in exercise, excluding high-risk patients from certain activities, promptly evaluating possible prodromal
symptoms, training fitness personnel for emergencies, and encouraging...