If you have heart disease such as major blockages, would it be better for your health if you remained sedentary rather than engage in an exercise regimen?
For certain individuals with underlying health conditions, physical activity can sometimes increase the risk of cardiovascular events.
Despite these risks, cardiologists stress that the benefits of regular exercise outweigh the potential dangers.
Data from two studies published in 2024 in CJC Open and the Canadian Journal of Cardiology offer new understandings into the risks associated with various physical activities, particularly focusing on natural deaths related to sport and recreation.
Cycling, hockey and hunting were identified as having the highest number of natural deaths in the Quebec, Canada region, with 95% of those being sudden cardiac deaths.
Researchers analyzed coroners’ reports, autopsy findings and police records from 2006 to 2019, and found that 2,234 deaths were associated with sport and recreational activities over the 14-year period.
Of these deaths, 297 were related to natural causes such as heart disease.
In 65% of cases, an automated external defibrillator (AED) was not available at the scene of death.
Philippe Richard, the lead investigator, noted that the lack of AEDs in remote or rural areas is a critical issue.
Dr. Carl J. Lavie, a cardiologist at Ochsner Heart and Vascular Institute in New Orleans, points out that while increasing the availability of AEDs in remote settings could reduce the mortality rate, the practical challenges of implementing such measures are considerable.
This study also offers practical applications for other physically demanding tasks such as snow shoveling.
For example, the risks associated with snow shoveling are often underestimated, and ensuring that individuals are aware of the potential for cardiac events during these tasks is an important aspect of preventing sudden deaths.
Exercise for People with Heart Disease: Beneficial or Harmful?
Additionally, researchers from the University of Toronto’s Sports Cardiology Program have explored the risks associated with exercise, particularly for people with heart disease.
Many cardiologists and family physicians have historically advised patients with heart conditions to limit their participation in sports and exercise, especially endurance activities, due to concerns about sudden cardiac events.
However, recent studies and expert guidelines have shifted toward a more balanced approach, noting that the risks of exercise-related cardiac events are much lower than previously believed.
These experts suggest that the risks of exercise should be considered in comparison to the risks associated with sedentary lifestyles, which are far more detrimental to overall health.
Dr. Paul Dorian, a lead investigator at the University of Toronto, and his team reviewed data comparing the risks of exercise to those of other daily activities.
He explained that conditions such as hypertrophic cardiomyopathy, often linked to sudden cardiac arrest, are less likely to result in catastrophic events than many people believe.
According to Dr. Dorian, athletes and those with heart disease should be in charge of their decisions about the level of physical activity they’re comfortable with, based on their personal values and preferences, rather than being solely restricted by medical advice.
Dr. Paul Poirier, a senior investigator at Laval University, agrees, stressing that the risk of sudden death during sports should not deter people from engaging in physical activities.
The sudden death during sport gets media attention when the player is a younger adult, creating the illusion that these events happen much more often than they actually do.
He noted that more people die from cardiac events while at rest, such as sleeping or sitting, than during physical activity. This also include during eating and intimacy.
A sedentary lifestyle is far more harmful than is participating in moderate to intense physical activities.
Overall, while the risks of sudden cardiac events during sports and physical activities can’t be entirely eliminated, the available evidence suggests that exercise remains a vital component of a healthy lifestyle.
The research shows that the benefits of consistent physical activity, including its positive effects on cardiovascular health, far outweigh the risks, especially when preventive measures such as access to AEDs, medical screening and CPR are in place.
Efforts to make emergency devices more accessible, particularly in remote and rural areas, could significantly reduce the number of deaths associated with sudden cardiac events during physical activities.
For individuals with heart disease, the evidence also supports the idea that engaging in exercise, including competitive sports, is relatively safe, provided they are properly screened and make informed decisions about their activity levels.
Safe Snow Shoveling Guidelines
First, always warm up before shoveling by stretching and performing light cardio, like walking, to prepare your muscles.
Hydrate as well, since the cold air can lead to dehydration.
When selecting a shovel, choose one with an ergonomic design, preferably lightweight and with a curved handle, to minimize strain on your back and wrists.
Lift snow carefully by using your legs instead of your back. Bend your knees, squat to lift and avoid twisting your body.
Always take small shovelfuls and try to push the snow rather than lifting it.
This reduces the risk of back strain and overall body strain including on the cardiovascular system.
Take frequent breaks to avoid overexertion and monitor your body for signs of fatigue.
Do not try to outpace your neighbor!
If you must take a break every five minutes or even less, then do so. Don’t try to prove that “you still got it,” especially if you have heart disease.
Shovel in layers, clearing light snow more often rather than letting it pile up.
Dress warmly in layers and wear non-slip footwear to avoid falls.
If you feel pain, lightheadedness, nausea or other discomfort, stop immediately.
Shoveling can strain the heart, particularly in those with heart conditions, so it’s important to know your limits and seek help if necessary.
