Moderate to vigorous physical activity protective against cardiac arrest
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Key takeaways:
- Moderate to vigorous physical activity was linked to lower risk for cardiac arrest.
- The benefits of physical activity were greater in women compared with men.
Vigorous physical activity of at least 20 minutes per week, shorter than that specified in guideline recommendations, was associated with reduced risk for cardiac arrest, according to findings published in EP Europace.
Additionally, moderate physical activity of up to 360 minutes per week, and not beyond, also sufficiently lowered risk for cardiac arrest, a duration in concordance with WHO, European Society of Cardiology and American Heart Association recommendations.
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WHO/ESC/AHA physical activity recommendations
“The WHO/ESC/AHA recommends that adults undertake at least 150 to 300 minutes of moderate physical activity or 75 to 150 minutes of vigorous physical activity weekly. Despite all the health benefits of physical activity, cardiac arrest incidence is transiently increased during physical activity, which is known as the paradox of physical activity. Cardiac arrest is disproportionately more likely to occur during physical activity, accounting for 6% to 17% of all cardiac arrests,” Shuangfa Qiu and Zhenhua Xing, MD, of the department of emergency medicine at the Second Xiangya Hospital and the Difficult Diseases Institute at Central South University in Changsha, China, wrote. “Herein, we explore the dose-response relationship between accelerometer-measured physical activity and cardiac arrest, with a particular focus on different intensities of physical activity. An important aspect of this study is the utilization of wearables to determine physical activity levels, a novel approach that adds a unique dimension to the assessment of physical activity-cardiac arrest association.”
For the prospective cohort study, Qui and Xing used data from 98,893 UK Biobank participants with physical activity data measured with a wrist-worn accelerometer.
Participants wore the accelerometers on their dominant wrist for 7 days at all times, including while working, walking and sleeping, according to the study.
Physical activity and cardiac arrest
Median follow-up was 7.31 years. During that time, the rate of cardiac arrest was 0.39 per 1,000 person-years.
Compared with the participants who spent 0 to 25 minutes weekly in vigorous physical activity, the researchers reported that those who spent 75 minutes or more in vigorous physical activity did not have significantly lower risk for cardiac arrest (HR = 0.61; 95% CI, 0.33-1.14).
Twenty minutes per week of vigorous physical activity, rather than the 75 to 150 minutes recommended by WHO/ESC/AHA, was sufficient to effectively lower incidence of cardiac arrest, as the risk beyond 25 minutes plateaued, according to the study.
Regarding moderate physical activity, participants who spent 600 minutes per week or more had a 49% lower risk for cardiac arrest compared with those in the 0- to 150-minute range (HR = 0.51; 95% CI, 0.32-0.81).
Moreover, risk for cardiac arrest decreased until approximately 360 minutes of weekly moderate physical activity, meeting the WHO/ESC/AHA recommendations, beyond which risk plateaued, according to the study.
“Cardiac arrest can result from various factors, including but not limited to cardiac death, drug toxicity, respiratory cause neurological event gastrointestinal case, endocrine/metabolic causes, etc. It is clear that cardiac death only accounts for 55% of cardiac arrest cases, highlighting the need for a more comprehensive understanding of the various contributing factors,” the researchers wrote.
“This study is the first to prospectively assess the association between device-measured physical activity and the long-term risk of cardiac arrest among the general population, providing more robust results than previous studies,” they wrote. “Disagreeing with previous studies, we found that moderate physical activity and vigorous physical activity were associated with lower cardiac arrest risk, which was not intermediated by sociodemographic, lifestyle factors and clinical characteristics. ... We did not find that vigorous physical activity can increase the risk of cardiac arrest, as found in previous studies, but might reduce the risk of cardiac arrest.”
In other findings, a stronger association between any physical activity and lower risk for cardiac arrest was observed among women compared with men.
“We also found that women benefited more from physical activity in reducing cardiac arrest, which cannot be fully explained by the fact that men had a nine to 19-fold higher risk of exertion-related cardiac arrest than women,” the researchers wrote. “Women still benefit from moderate physical activity which might not be intense enough to trigger cardiac arrest. Further studies are required to unveil this phenomenon. These findings indicate that individuals can choose individualized strategies to benefit from physical activity based on their willingness.”
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