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A new study highlights the importance of movement in significantly reducing heart attack risk, especially for those who have already experienced one.
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Sedentary behavior is a big driver of heart disease risk because it inhibits blood circulation, among other detriments.
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Experts explain the research and what to do to boost heart health.
There are around 335,000 recurrent heart attacks in the United States each year, according to the American Heart Association (AHA). Findings from a new study say that adding 30 minutes of exercise to your routine has the potential to decrease that risk by as much as 60%.
Meet the Experts: Srihari Naidu, M.D., professor of medicine and cardiology at New York Medical College and president of the Society for Cardiovascular Angiography & Interventions; and Robert Segal, M.D., founder of Manhattan Cardiology, Medical Offices of Manhattan, and co-founder of LabFinder.
Experiencing one cardiac event is scary, and subsequent hesitation to return to normal life, especially when it comes to making changes to your routine, is valid. However, new research indicates that doing moderate exercise cuts the risk of a recurring heart event by more than half. Below, experts break down the how and why, including what you can do to lower your chances of experiencing a heart attack.
What did the study find?
Research published in Circulation: Cardiovascular Quality and Outcomes found that replacing sedentary behavior with movement of any kind can lower repeat heart attacks. The study followed over 600 New York City emergency room patients who were discharged after being diagnosed with symptoms of acute coronary syndrome, a term that describes a range of conditions related to sudden reduced blood flow to the heart, including a heart attack and unstable angina. Patients were enrolled from 2016 to 2020 and wore wrist accelerometers, devices that measured physical activity and sleep, for 30 days after their initial emergency room visit. Within a year, 8.2% of participants experienced a cardiac event or died. The study found that those who spent more than 10 hours a day sitting or remaining still for prolonged periods had a significantly higher risk of experiencing another cardiac event.
Researchers used questionnaires to divide people, post-cardiac event, by their activity levels on a scale of sedentary, light-intensity activity, and moderate-vigorous activity for the year following hospitalization. The questionnaires also asked participants if they increased their sleep. Researchers then compared the number of repeat heart events over that year to those factors (activity level and sleep) and concluded that replacing 30 minutes of sedentary time with exercise or sleep lowers one’s chance of experiencing a recurring cardiac event or dying.
Exercise was found to be the most beneficial, as those participants had 50 to 60% fewer heart attacks or cardiac events over the following year. “Importantly, it doesn’t seem to matter how much exercise you do, but rather, you avoid being truly sedentary,” explains Srihari Naidu, M.D., professor of medicine and cardiology at New York Medical College and president of the Society for Cardiovascular Angiography & Interventions.“The larger gains were made in those who regularly exercised, with moderate to high intensity having perhaps a little more benefit than light exercise, but not significantly so.”
Sleep also showed to have some preventative effect, likely due to its restorative nature, Dr. Naidu says.
How might sedentary behavior increase heart attack risk?
Remaining sedentary “does not challenge the system to improve vascular health,” Dr. Naidu explains, which is especially crucial for people like the study participants, who were recovering from a heart event. “Exercise increases the health of all the blood vessels, reduces blood pressure, and produces endorphins that elevate mood and fight depression, all things very much needed after a heart attack,” he adds.
Robert Segal, M.D., founder of Manhattan Cardiology, Medical Offices of Manhattan, and co-founder LabFinder adds that sedentary behavior contributes to insulin resistance, which raises type 2 diabetes risk and increases the likelihood of blood pressure surges after standing up. “These issues occur independent of how much intentional exercise you do after a heart attack,” he explains. “Imagine your blood vessels are like a river system. Movement is the current that keeps everything flowing. Sitting still for hours is like damming up a stream—things get sluggish, pressure builds, and debris (in this case, fats, glucose, clots) accumulate in the blood vessels.” Be sure to consult your physician before adding exercise to your routine post-heart event, as they’ll better inform you on what’s best for your particular needs.
How exercise lowers heart attack risk
Our experts stress that after you consult your doctor and they give you the go-ahead, exercising after a cardiac event shouldn’t be dangerous. In fact, “when done thoughtfully,” Dr. Segal notes, after completing a prescribed cardiac rehabilitation program, it may be beneficial. “Think of your heart like a muscle that’s been bruised. It’s not broken, it’s healing,” says Dr. Segal.
This study suggests that replacing sedentary behavior with movement—not just going to the gym a couple of times per week—makes a huge difference. In other words, it’s not only about the peaks, or exercise sessions, Dr. Segal explains. It’s about reducing the valleys, or prolonged sitting. “The goal is rhythmic circulation throughout the day. The study shows that breaking up sitting time and being lightly active reduces your risk more than you’d expect—especially for people who’ve already had a cardiac event,” he concludes. Even standing up and walking around the room can make a difference.
You don’t have to be a weekend warrior, Dr. Naidu says, but perhaps a daily stroller.
How sleep lowers heart attack risk
In addition to exercise, the study found that replacing just 30 minutes of sedentary behavior with sleep could be heart-protective. “Sleep has a variety of health benefits that are involved in healing and mental health, and this is becoming increasingly clear,” says Dr. Naidu. “Sleep helps regulate blood pressure, manages craving, and thereby improves diet, and gives the heart a rest. Heart rate and blood pressure are normally low at night, and this may be part of heart recovery. Appropriate sleep also reduces stress and provides the energy to be able to exercise.”
Dr. Segal agrees and adds that poor sleep increases inflammation, blood pressure, and arrhythmia or irregular heartbeat risk.
What limitations did the study have?
The study didn’t challenge patients to increase their exercise, but merely sampled their routine after a cardiac event, explains Dr. Naidu. “Thus, the study does not help us know that actively changing your exercise behavior improves your risk,” he adds. “But it makes sense that it would, and we have significant data from other studies of cardiac rehab programs to show that they work.”
The bottom line
Dr. Naidu says that the biggest takeaway from this research should be that “doing anything other than being sedentary can have strong heart benefits, including reducing heart attack risk by as much as 60% over even one year.”
Also, Dr. Naidu notes that such exercise was beneficial to participants “on top of taking all the right medications.” So, if you or a family member is a survivor of a cardiac event, it’s advised to work closely with your cardiologist to develop a treatment plan that includes exercise as well as other heart-healthy habits, like eating a balanced diet and avoiding tobacco.
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