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Sudden Death Heart Attacks Rare in Women While Exercising - Men are 19 Times more Likely to Die - But Moderate Exertion Will Lower Long Term Risk

March 21st 2006

Sudden Death Heart Attacks Rare in Women While Exercising - Men are 19 Times more Likely to Die - But Moderate Exertion Will Lower Long Term Risk

Dr. Albert

There were three heart attacks and two deaths associated with the heart attacks at the Los Angeles Marathon the other day.  Experts want to remind people that sudden cardiac death during exertion is extremely rare in women.  All three heart attacks at the marathon involved men and this was the first time there was more than one heart attack during the LA Marathon.

Typically regular exercise may significantly lower the long-term risk, according to a study in the March 22/29 issue of JAMA, a theme issue on women's health.  Always check with your doctor before you begin an exercise regimen.

Sudden death heart attacks are more likely to strike men than women.  Christine Albert, M.D., told NBC reporters in an interview that "In comparison to a prior study that we did among male physicians, the risk of sudden cardiac death during vigorous exertion was approximately 19 times higher in men than in women."


The studies author was Christine Albert, a doctor at the Brigham and Women's Hospital, Cardiovascular Division, Center for Arrhythmia Prevention. The research data was extrapolated from the Nurses’ Health Study, which began in 1976 when 121,701 nurses aged 30 to 55 complete questionnaires about their coronary heart disease (CHD), risk factors, lifestyle and medical history.  There were follow ups every two years for up to 28 years.  Of the total, 84,888 women provided information on their amount of moderate to vigorous exercise per week in 1980, 1992, 1996, 1998 and 2000. 

According to the study there were 288 cases of sudden cardiac death among the 84,888 women who completed the 1980 questionnaire.  Although there were nine deaths associated with moderate to vigorous exertion (death may have occured soon after), only three of the deaths occurred while exercising.  The researchers said “Of 69,693 women without a history of CHD, stroke or cancer at the study's beginning, 32 percent (22,172) reported no regular moderate to vigorous exercise and 15 percent (10,680) reported exercising for four or more hours per week.”


The risk of sudden cardiac death associated with moderate to vigorous exertion was "exceedingly low."  The rate was 1 per 36.5 million hours of exertion.  Here the risk was “temporarily elevated during moderate to vigorous exertion, compared with the risk during lesser or no exertion.”   

Exercise may have actually lowered the temporary risk.  The researchers said “Regular moderate to vigorous activity lessened this temporary risk, and was also associated with a lower long-term risk of sudden cardiac death.”

The bottom line is that avoiding exercise to avoid cardiac arrest is not well founded. The authors of the study wrote "Although our data are consistent with prior analyses in men that suggest that physical exertion may trigger sudden cardiac death and that habitual exercise diminished this risk, the magnitude of the risk is much lower in this cohort of women compared with a similar cohort of men."   

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