Cycling v Heart Attack

[Downhill]

Some years ago a family member of mine (a keen cyclist for many years) died from a heart attack within hours of completing a cycling event. This week I was saddened to hear about Mr Rummukainen, also a keen cyclist, who passed away under very similar circumstances. It got me thinking.

Obviously cycling has enormous health benefits. Is there any evidence to suggest that cycling could also contribute to the risk of heart attack in older cyclists more than other sports? Or is it simply a case of reducing the risk factors, avoiding extremes and exercising appropriately?

[sogood]

One's ticker can just as easily go during or post bed exercises, if the exertion level is "right". Cycling is not the issue but safe exertion level for the underlying health state is.

[greyhoundtom]

Being an older guy the thought that my cycling endeavours may precipitate a heart attack is something you do think about from time to time.

But then any strenuous exercise, if your heart has an underlying problem, is likely to do the same.

The problem with cycling is that the HTFU option is pretty well enshrined in the lycra/road bike type of cycling, and the temptation to simply ignore pain and or shortness of breath and to just keep pushing is very strong.

I have recently learned some hard lessons in this regard, and now know that to just HTFU while cycling is an extremely stupid and immature attitude that can lead to all sorts of health and injury problems, and in extreme cases even death.

[MichaelB]

During a recent checkup with my GP, discussed this issue at length as well, as in Adealide, there have been a few similar events in recent times.

One of the observations was that for some other patients with similar concerns (not his) did a stress test (on a stationary bike), and it was this stress test that caused a cardiac issue where a blood vessel burst due to a plaque buildup (note, that is my summary in not doctor speak).

In the end, if all the markers (BP, cholesterol, extc) are good, and common sense is used, sometimes, stuff happens, and you can't always predict.

The reality is that you are more likely to be killed in a car accident or struck by a car riding. Sadly.

Stay healthy, and ride to yiour limits (as mentioned by sogood) and enjoy riding.

[Sweeper59]

There's far more people die from heart attacks while just sitting quietly in front of the TV, than from cycling.

I'd rather risk having a cycling accident while maintaining my fitness, than sit at home and lose all the benefits that come with being fit - including having a healthy heart.

[sogood]

There are other relevant issues for cyclists in the heart stress group. Given our physical abilities starts to deteriorate along with every other parts of our body, just like the heart, the slower reaction time with increasing age is another that should be managed. Riding on the road requires considerable acuity and agility and a few ms delay in one's response can lead to serious injuries. Recognise and manage appropriately so that cycling remains beneficial for health and is enjoyed.

[winstonw]

One's ticker can just as easily go during or post bed exercises, if the exertion level is "right". Cycling is not the issue but safe exertion level for the underlying health state is.

Do bed exercises increase risk for men and women equally?

It is hard to say whether a cyclist would not have had a heart attack earlier if they didn't cycle.
As usual, moderation in most things is more important the older one gets. That's a big part of what wisdom is.
Some don't want to accept that in the words of Buddha, "decay is inherent in all living things". Try as we might, no one has stopped the decay process.
The following article puts heart attack risks into clearer perspective. It seems post exercise HA risk is more likely amongst irregular and infrequent exercisers.
It would be interesting to study risk amongst regular high intensity exercisers.

Another thing that we should all be mindful of is heart rhythm abnormalities. These can be unmasked and exacerbated by intense exercise, and these are a risk factor for HA. Medical associates tell me there is a rapidly growing incidence of these amongst the middle aged. Though obesity and sedentary lifestyle are just as likely to cause it.

Incidentally, I chatted at length with an older cyclist last Saturday after we both raced; and he conveyed that was his first race since his heart attack 2 years earlier. A few of us quizzed him about the HA. It happened when he was cycling home about 20 minutes after a race. He got sweaty, weak, and dizzy, and had to pull over. He called his wife, and she took him to the doctor, who immediately called an ambulance.

All this is good reason to review your diet and talk to your doctor about BP and prophylactic use of aspirin.

[sogood]

It seems post exercise HA risk is more likely amongst irregular and infrequent exercisers.

I wonder if the study considered the weeding effect in those who exercised regularly?

[brentono]

11.11.11

My Father died (instantly) of HA while out riding. RIP.
Brentono

[winstonw]

I wonder if the study considered the weeding effect in those who exercised regularly?

Good point.

As with many lifestyle studies, lots of room for selection bias and confounding of causal relationships. New, irregular, or infrequent cyclists are more likely to have issues with co-morbidities, be sporadically motivated to lose weight/"get fit", or be time poor with other life stressors....as I was when I started cycling.

The link I meant to include earlier.
http://edition.cnn.com/2011/HEALTH/03/2 ... index.html

[sogood]

Thanks winstonw. At the end of the day, it really just comes down to common sense. If one cares to read scientific literature, then it's important to cover broadly and maintain a perspective. Irrespective, act in moderation is a time tested word.

[gorilla monsoon]

My friend died of a heart attack while standing in a queue at the bank. He hated cycling (but not cyclists. He just didn't like the thought of doing anything energetic) and it was probably his sedentary lifestyle and love of food that did the deed.

[foo on patrol]

You have just as much chance of it happening while vacuuming the house. If we all worried about it, then we wouldn't exercise.

Some people are a ticking time bomb and don't know it unfortunatly.

Foo

[DaveOZ]

Life is a lottery, I'll take my chances on the bike.

[sogood]

Life is a lottery, I'll take my chances on the bike.

Just make sure it's the flashiest in the bunch with deep aero rimed wheels!

Don't care about CF or steel or titanium or Mg. That's a personal choice as long as it's flashy!

[wombatK]

Is there any evidence to suggest that cycling could also contribute to the risk of heart attack in older cyclists more than other sports? Or is it simply a case of reducing the risk factors, avoiding extremes and exercising appropriately?

The only evidence I know of is the studies of marathon runners who collapsed and died from heart attacks - sometimes at the end of the race, but some times a day or two later. That doesn't stop my cardiologist from competing in tri-athlons. He says the evidence is that most of those who get into trouble are the ones who don't allow adequate recovery time. So that's near the top of the list of what it means to avoid extremes and exercise appropriately. Being vigilant about hydration is also up there near the top.

If you have any more concrete reasons to be concerned, like dizziness, shortness of breath, irregular heartbeat, numbness in limbs, chest, arm or shoulder pain being associated with exercise, then you should not waste any time getting a referral to a cardiologist for more specific checks and recommendations.

[Chuck]

I'd rather risk having a cycling accident while maintaining my fitness, than sit at home and lose all the benefits that come with being fit - including having a healthy heart.

+1

[Ken Ho]

There is an interesting discussion of this issue on slowtwitch by Dan Empfield, where he talks about the issue of getting "heart tired". Look under the training section.
I'm inclined to follow his line of thought, and while I like to HTFU, I'm mindful of getting heart tired. I don't use HR as a training guide, for example.
Traditionally, the commonest time to have a heart attacks is around 5 am, with a BP spike occurring at that. That's probably changing, with long acting BP meds controlling that.
As an ED doc, I see people coming in at all times of day and night, with no particular association with exercise. The toilet has always been a popular place to cark it too, and I've certainly been called to plenty of arrests in hospital toilets.

[sogood]

The toilet has always been a popular place to cark it too...

Never take your eyes off that patient who wants to go to the toilet. Poo poo is coming!

[blossy84]

11.11.11

My Father died (instantly) of HA while out riding. RIP.
Brentono

I'm sorry to hear that Brentono

[trailgumby]

11.11.11

My Father died (instantly) of HA while out riding. RIP.
Brentono

I'm sorry to hear that Brentono

Sorry, I kinda passed over that...

Are you saying that he passed away on Friday while out on the bike?

[R12RT]

I was talking to guy on my Saturday group ride who I han't seen for awhile.

It turns out that he had a heart attack on a group ride several weeks previously. He complained about feeling I'll and left the ride early. He rode home which took about an hour. When he got home his wife told him he looked awful and took him to the doctor.

Tests revealed that one of his arteries was 70% blocked. His cardiologist said that if it wasn't for his high level of fitness he would have probably died.

After several weeks of the bike he is back on it and trying to regain some lost fitness.

[brentono]

11.11.11

My Father died (instantly) of HA while out riding. RIP.
Brentono

I'm sorry to hear that Brentono

Thanks Erin,
A couple of years ago, but a rememberance of a veteran.

[wombatK]

There is an interesting discussion of this issue on slowtwitch by Dan Empfield, where he talks about the issue of getting "heart tired". Look under the training section.

Linky: How much is too much

As the article explains, there is a gap between what medical science has proven and what endurance athletes anecdotal evidence suggests. Empfield offers some tentative theories on what might underlie it, but we probably need someone to do more definitive research.

[sogood]

Linky: How much is too much

As the article explains, there is a gap between what medical science has proven and what endurance athletes anecdotal evidence suggests. Empfield offers some tentative theories on what might underlie it, but we probably need someone to do more definitive research.

"Heart Tired" is a terrible term! One that misleads people. As indicated in the article, heart can not get tired, and the likely candidate being that of the external neuro-hormonal factors that control the heart. Heart muscles are better than Duracell batteries.