Yes, those who exercise can still get a heart attack, but at least this means they’re less likely to die from a heart attack when compared to sedentary people.

You can still get a heart attack despite exercising. However, it’s still your worthwhile—in a tremendous way—to make exercise a part of your life.

That’s because new research shows a “dose-response” relationship between how much exercise a person has been doing, and the likeliness of surviving a heart attack.

And even though you can still suffer a heart attack despite being physically active, it’s well-established that exercise protects against cardiac events.

The latest study “suggests that myocardial infarctions [heart attacks] are smaller and less likely to be fatal in animals that exercise,” says lead study author Eva Prescott, in the report that appears in the European Journal of Preventive Cardiology (April 2017).

How was the study on people done?
• The 14,223 participants of the Copenhagen City Heart Study were included.
• At the beginning of the study, none had a history of heart attack or stroke.
• Physical activity levels were grouped as sedentary, light, moderate or high.
• The study began between 1976 and 1978.
• Participants were followed through 2013; 1,664 had heart attacks; 425 died immediately.

The exercise levels of those with instant deaths was compared to those who survived.

Results of the Study
Heart attack patients with a history of light or moderate/high exercise were 32 percent and 47 percent, respectively, LESS likely to die from the event, when compared to sedentary subjects.

“There was also a dose-response relationship,” says Prescott, professor of cardiovascular prevention and rehabilitation, University of Copenhagen, Denmark.

The chances of dying from a heart attack “declined with the level of exercise they did,” says the report, “reaching an almost 50 percent reduction for those who were the most physically active.”

Why does exercise lower the odds of dying from a heart attack?
Professor Prescott’s report points out “collateral blood vessels in the heart,” which can be developed from exercise.

These adjunct blood vessels help supply the heart with oxygen even though a major artery is blocked with a clot.

Another explanation offered is that of “levels of chemical substances that improve blood flow,” says the report, “and reduce injury to the heart from a heart attack.”

Professor Prescott, however, also notes that the study was “observational,” meaning, that the link between how much exercise one does and the survival odds for a heart attack is associative rather than causal.

In other words, is there something directly about exercise that increases the survival odds should that person suffer a heart attack?

The study looks pretty convincing, don’t you think? Prescott adds that these findings “might indicate that continuing to exercise even after developing atherosclerosis [heart disease] may reduce the seriousness of a heart attack.”

How is it that people with a high degree of exercise in their lifestyle suffer a heart attack in the first place? First of all, the level of activity that was reported in this study was a subjective account by the participants.

We don’t know just what constituted “moderate” or “high” in this analysis. We only know that, based on relative comparisons, “high” was correlated to the greatest chance of surviving a heart attack, and lack of exercise was linked to the lowest chance.

Maybe there were some marathon runners, mountain climbers and bodybuilders in that 14,223 group, but being that only a very tiny percentage of any random selection of 14,000 people would be marathon runners, mountain climbers, bodybuilders or triathletes, it’s logical to assume that this tiny percentage of truly “high” physical activity applied to the 14,223 participants.

Nevertheless, people who do what would be considered a lot of good exercise can still suffer a heart attack. Dr. Alvaro Waissbluth, a heart surgeon, explains how this is possible in this article.